in product development need to be calculated and communicated to achieve an accurate estimate and understanding of the total risk.
Cancer risk comparisons. Doll and Peto (1981) conducted one of the earliest and best‐known studies to put cancer risks in perspective.16 The research team analyzed data for a variety of causes of cancer, including industrial products, pollution, food additives, tobacco, alcohol, and diet. Results of the study provided a comparative perspective on cancer risks. The study found, for example, that the combined effect of food additives, occupational exposures to toxic agents, air and water pollution, and industrial products account for only about 7% of US cancer deaths.
The results suggested that removing all pollutants and additives in the air, water, food, and the workplace would result in only a small decrease in cancer mortality. However, Doll and Peto pointed out that even this small percentage represents a substantial number of lives. Doll and Peto also pointed out that associations and correlations, no matter how powerful or large, do not mean causation. Only when all other available information is brought into the picture can a true causal relationship be shown.
EPA’s “Unfinished Business” Risk Comparison Study. In 1987, the EPA published a landmark study of the risks associated with the thirty‐one risk problems regulated by the agency titled Unfinished Business: A Comparative Assessment of Environmental Problems.17 The purpose of the study was to determine if the agency could be more effective in its risk decision‐making and management activities.
EPA staff were assigned to four working groups: the Cancer Risk Working Group, the Non‐Cancer Health Effects Working Group, the Ecological Effects Working Group, and the Welfare Effects Working Group. Each working group looked at the same set of 31 risk problems and attempted to estimate the risks for each in their assigned areas. The results were then integrated to provide a basis for comparing the seriousness of the different risk problems. Risk problems that received relatively high rankings in three of the four working group categories, or at least medium rankings in all four, included outdoor air pollutants (for example, carbon monoxide, nitrogen oxides, and sulfur dioxide), stratospheric ozone depletion, and pesticide risks, including residues on food.
Risk problems that ranked relatively high on health but low on ecological or welfare effects (or that by definition were not considered an ecological problem) included radon, toxic air pollutants, indoor air pollution (other than radon), drinking‐water contamination, pesticide application, consumer products, and worker exposure to chemicals. Risk problems that ranked high on ecological and welfare effects but low or medium on health effects included global warming, sources of surface‐water pollution, physical alteration of aquatic habitats (including estuaries and wetlands), and mining wastes. Areas related to groundwater consistently ranked medium or low. Two problems for which information was particularly scarce – biotechnology and new chemicals‐were considered very difficult to rank.
The EPA report found that its current risk management priorities did not correspond well with these risk rankings by its risk assessment experts. For example, the agency identified the following problems as “relatively high risk/low agency effort”: indoor radon; indoor air pollution; nonpoint sources of surface‐water pollution; discharges into estuaries, coastal waters, and oceans; other pesticide risks; accidental releases of toxics; consumer products; and worker exposures. Conversely, areas of high EPA effort but relatively low risk included Superfund hazardous waste sites, underground storage tanks, and municipal landfills.
The EPA report noted these divergences were not necessarily inappropriate. Some of the risk problems ranked as low in risk were low precisely because of efforts by the agency to reduce them. Other risks, such as those involving consumer products and worker exposures, are primarily the statutory responsibilities of other agencies, such as the Consumer Product Safety Commission and the Occupational Safety and Health Administration. Perhaps most importantly, the EPA report noted that risk estimates are only one of several other factors that determine EPA risk management priorities. These factors included the economic or technical controllability of the risks; the social, cultural, political, and psychological aspects of the risks (such as the degree to which the risks are perceived to be voluntary, controllable, familiar, or equitable); and the benefits of the activities that generate the risk.
The report noted that the EPA’s risk management priorities corresponded well with public opinion. Survey data indicated that the public identified hazardous waste disposal, industrial accidents, and air pollution as high risks. The public ranked oil spills, worker exposures, pesticides, and drinking‐water contamination as medium risks. The public ranked indoor air pollution, consumer product risks, genetically modified organisms, radiation (other than nuclear power plants), and global warming as relatively low risks.
In a follow‐up article authored by an EPA official (Allen, 1987), the disparities between expert rankings of risk and public rankings of risk were explored in greater depth. For example, the article noted that beginning in the 1970s and 1980s, climate change and global warming was increasingly being recognized by scientists as a serious environmental problem. As a result, the EPA working group ranked global warming a relatively high risk. However, the public ranked global warming as a relatively low risk. Allen noted:
The EPA task force ranked it high because of the massive potential implications for the entire world. The most probable explanations of the low public ranking are the following: 1) the consequences are very much in the future and hard for many to imagine because they extend beyond ordinary experience, 2) the problem is diffuse and there are many causes (i.e. there is no one person or thing to blame), and 3) there is simply a general lack of public familiarity with the issue.18
4.2.4.3 Stage 3: Stakeholder Engagement
The third stage of risk and crisis communication is built around stakeholder engagement and dialog. The publication of the Seven Cardinal Rules of Risk Communication by the EPA in 1988 as an official policy guidance document was an important third‐stage event.19 Two central premises of the EPA document were that people have a right to participate in decisions that affect their lives, and what people often mean by risk is much more complicated than what technical experts often mean by risk. The document argued that risk communication messages must be based on an understanding of how people obtain information, what values guide their interpretations of information, what role emotion plays in forming perceptions, how people make trade‐offs, and how people arrive at their final attitude and behavior toward a risk.
In the third stage of risk communication, a profound paradigm shift in thinking took place. Risk was seen as consisting of two almost independent, basic elements: technical risk and emotion. Understanding risk required understanding the interaction of these two elements as they intertwined. The advantage of the “technical risk + emotion” concept was that it served to reframe the problem. It allowed risk managers and decision‐makers to consider the many factors included in the public’s definition of risk, such as trust, benefits, voluntariness, control, and fairness. This new, expanded concept of risk also pointed to the need for authentic and meaningful dialog among all interested parties. It led to the then revolutionary idea that the essence of risk communication is not just explaining risk numbers but listening, engaging in constructive dialog, and negotiating in good faith. Third‐stage success requires that it is not enough for risk managers and communicators to acknowledge people’s emotions and concerns by listening to them, they must also actively communicate their understanding that people are entitled to be emotional and concerned, and why.
An excellent example of third‐stage risk and crisis communication occurred in the late 1980s. Medical waste was floating up on the shorelines of the northeastern
