Practical Opportunities to Improve the Impact of Health Risk Assessment on Environmental and Public Health Decisions

Following alerts about the diminishing role of health risk assessment (HRA) in informing public health decisions, this study examines specific HRA topics with the aim of identifying possible solutions for addressing this compelling situation. The study administered a survey among different groups of stakeholders involved in HRA or decision-making, or both. The responses show various understandings of HRA in the decision-making context-including confusion with the health impact assessment (HIA)-and confirm recurring foundational issues within the risk analysis field that contribute to the growth of inconsistency in the HRA praxis. This inconsistency lowers the effectiveness of HRA to perform its primary purpose of informing public health decisions. Opportunities for improving this situation come at the beginning of the assessment process, where greater attention should be given to defining the assessment and decision-making contexts. Both must reflect the concerns and expectations of the stakeholders regarding the needs and purpose of an HRA on one side, and the methodological and procedural topics relevant for the decision case at hand on the other. The HRA process should end with a decision follow-up step with targeted auditing and the participation of stakeholders to measure its success.

The Role of Decision Analysis in Risk Analysis: A Retrospective

In commemorating the 40th anniversary of Risk Analysis, this article takes a retrospective look at some of the ways in which decision analysis (as a "sibling field") has contributed to the development both of the journal, and of risk analysis as a field. I begin with some early foundational papers from the first decade of the journal's history. I then review a number of papers that have applied decision analysis to risk problems over the years, including applications of related methods such as influence diagrams, multicriteria decision analysis, and risk matrices. The article then reviews some recent trends, from roughly the last five years, and concludes with observations about the parallel evolution of risk analysis and decision analysis over the decades-especially with regard to the importance of representing multiple stakeholder perspectives, and the importance of behavioral realism in decision models. Overall, the extensive literature surveyed here supports the view that the incorporation of decision-analytic perspectives has improved the practice of risk analysis.