Management Of An Environmental Risk Health And Social Care Essay
With the advent of globalization exposure to environmental and occupational hazards has increased by many folds. Not only has the domain of health risk assessment become of great interest for policy makers but has driven quite an audience from among the public and academia. Recent years have hence demonstrated a focus from all sectors on, risk management as it facilitates decision making, ascertains acceptable risk, shows legal compliance, ensures priorities are properly set, aids risk communication and creates access to scientific information for organizations. These in term have protected shareholders interests and paved means to achieve overall company objectives. The current assignment provides an evaluation of various risk assessment methodologies. This essay aims at providing an overview of the development of risk assessment starting from where risk and risk management evolved. It would take an overview of the various ideologies of risks. Furthermore the essay would critically evaluate the utility of risk assessments and its role in improving/ protecting health and safety in society. Along with outlining the basic utility of risk assessment, it would also provide an over view of the limitations associated with the process. Last but not the least we will evaluate two most common risk assessment methodologies.
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Understanding of risk has travelled down from various ideologies .Risk as a concept was originally formulated from statistical understanding of how to avoid losing games of chances (Peter L. Bernstein, 1996). According to (Peter L. Bernstein, 1996, pp. 47-54) the sixteen century physician Girolamo Cardano's ( 1500- 1571) credentials as a gambling addict appear to have paved the means to first serious efforts towards the development of statistical principles of probability in other words risk avoidance. This was followed by the great contribution of Pascal and Pierre's (1654) theory of probability (Peter L. Bernstein, 1996, pp. 60-70).Epidemiological development of the concept by John Graunt (1662) in his Natural and political observation made upon the bills of mortality pronounced risk as a probability of an unwanted event (Peter L. Bernstein, 1996). As a the concept of what risk actually is, risk has evolved from an understood for something statistical, to something which was a perception (Slovic P , 1987).Risk was broadly understood as a function of knowledge, trust and perception and the aim of a risk analysis was maximization of knowledge and trust through science based assessments that minimises relativism in risk based decision making (Slovic P , 1987, pp. 280-287). Risk Analysis by large encompasses the assessment along with the management and communication of risks keeping into consideration also how it is perceived and compared (ACS, 1998) Risk assessment and management have relevantly more recently evolved as discipline regulated by legal compliance for health and environmental hazard and risk (NRC, 1983). According to (Jeffrey D. et al , 2000) the foundation of risk analysis lies in risk assessment, which can be defined as objective evaluation of risk, keeping in minds the assumptions and uncertainties. Despite the numerous varying international frameworks of risk analysis , most of them have a clear focus of sound conduct and scientific backing (Power & McCarty, 1998) as cited in (Jeffrey D. et al, 2000).
Although there are numerous differing international frameworks for risk analysis, the seminal volume, Risk Assessment in the Federal Government: Managing the Process (NRC, 1983), commonly referred to as the "Red Book", is the basis point of reference used (D. Kofi Asante-Duah, 2002 ) (Farmer R & Lawrenson R., 2004)).
The national research council has contributed largely towards how risk assessment is known and understood today. The National Research Council has been a persistent voice behind encouraging the need for risk assessments; they have contributed hugely in formulation of risk assessment by providing frame works and guidelines. The form of risk assessment which is in practice today follows the 'Red Book' paradigm, which was promulgated by the NRC in the year 1983. The Red Book acknowledged risk analysis as a formalized discipline and tool which contributed towards policy decision making and Implementations (WHO, 1995).
Under this paradigm , risk assessment is a science driven process that evaluates risk probability based on quantitative reasoning.It describes risk assessments to follow a logical ,stepwise means of problem formulation through the characterization of effect , exposure and risk ( National Research Council (NRC), 1983).This paradigm lays huge emphasis on scientific scrutiny of issues of concern. The assessment is based on exposure refinement and it proceeds by tiers (American Chemical Society (ACS), 1998).
Along with science risk managers keep an open consideration for social, cultural, economic and politician interventions and their impact on policy implementation (Jeffrey D et al , 2000) (Mark C. et al, 1994). Risk assessment is evolving as a concept from the Red Book paradigm to a process which is an integrated approach for science and policy inputs, the 'orange Book' Paradigm; NRC,1996). The growing popularity of the Orange Book paradigm for analysis of risk demonstrates the new role of policy specialists in risk determination. This paradigm shifts the risks from a scientifically driven enterprise to an 'analyst -deliberative' process where all interested parties determine how to address uncertainities.This ensures transparency and improves knowledge and builds trust among public (Jeffrey D. et al, 2000). This shift of focus from one paradigm to the other illustrates the role of knowledge in building public acceptance to environmental risks. The potential challenge of effectively implementing the orange book deters the way risk is perceived and responded to, in our societies.
Risk assessment plays a huge role in modern society .The importance of its role can be viewed in the light of , what contributions it makes .Risk assessment is a careful examination of the potential hazards at the workplace and so one can check whether all the precautions are taken or does one requires more to prevent harm. Risk assessment hence in this respect is proactive means of avoiding cost, associated with health and safety, accidents, claims and loss of productivity in form of absence from work (The Royal Society, 1992) (Health and Safety Laboratories, 2003).
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Risk assessment is one of the most fundamental aspects of good health and safety practice. It provides essential insights on occupational hazards and thus helps to improve worker health and safety (Smith, C.M. et al., 1994). One of the benefits of risk assessment is that the processes become more efficient. There is an increase in productivity and customer satisfaction. According to health & safety rules and regulations a company becomes legally compliant by carrying out risk assessment. Such legal compliance makes it a safe place to work at for the employees (Huczynski, Buchanan D., 1997). Legal compliance also ensures that the company is free of any expenses paid in forms of fines, penalties and law suits. Such organizations also manage to build their brand names under the banner of good employers as they put employee safety first and hence their image in the minds of potential employees is enhanced (Farmer R & Lawrenson R., 2004)).Increase in productivity is only possible if the company has a healthy workforce that is safe from all kinds of hazards. Therefore risk assessment definitely improves health & safety at the workplace, which in terms increase the company productivity as mentioned above as well
According to Duah (2002) risk assessment is considered as an effective management tool as it helps in decision-making process concerning health & safety issues. Basically it aids the decision-making process and should be the main focus during the entire risk management process. It also helps to come up with technically feasible and justifiable corrective actions that will help protect public health and the environment in a cost-effective manner (Glenn Robert Koller, 1999). Koller (1999) argues that risk assessment is a universal and generic tool that can be incorporated to measure health and safety risks and provide necessary protection accordingly.
Basically the goal of risk assessment is to remove hazards and mitigate the level of risk at the workplace by adding precautionary measures. In the process a safer and healthier workplace is created. And this workplace is staffed by happy, healthy and productive employees (Huczynski, Buchanan D., 1997)Â By far the most important role of risk assessment is with regard to policy making and decision making .
Â Risk assessments however are not without flaws and limitations. In order to gain a better understanding of the risk assessment and analysis, it is important to take a look at the short comings of the process. In order to anticipate all possible outcomes risk assessment needs to be very comprehensive in nature, which can be very difficult given the limited time and resources for the assessment (American Chemical Society (ACS), 1998). Risk assessment also needs to be directed towards those responsible individuals who are to make decisions based on the assessment however it also is vital that the findings are in line with scientific principles, legal requirements and public values (Slovic P , 1987). This can often result in difference of interests. Legal requirements and public values may not always be in favour of the needs of businesses. Hence the idea is to provide the decision maker with as much assistant as possible within the framework of available resources including time. To achieve these objectives it is necessary that the analyst is well trained and has the required skills and scientific rigour. Hence one big limitation of risk assessment is the person factor that is that the quality of the risk assessment and the ability for it to provide robust and accurate information to decision makers is based on the person conducting the risk analysis. As they are dependent on his skills, his qualification and training on statistical tools and qualitative interpretations/ judgement (Health and Safety Laboratories, 2003) (The Royal Society, 1992).It is a known fact that risk assessment is the scientific analysis of a given risk. To gauge the probability and severity of the adverse outcomes associated with the study requires full use of available objective data. In a majority of the cases such data does not exist, due to lack of knowledge o experience. This requires a need for utilizing good judgement for making decisions (D. Kofi Asante-Duah, 2002 ). Scientific expert opinion in such case can be difficult to find firstly due to the basis lack of presence of such expertise secondly scientist often show reluctance to express a judgement of a controversial decision.
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Keeping into mind the limitations discussed above, we will evaluate two very common observational epidemiology methodologies .As a part of our evaluation we would attempt to consider the usage, advantages and disadvantages for the two risk assessment. Cohort Studies are most popularly used to determine incidence and natural history of a conditions .These can either be prospective or retrospective in nature. Cohort studies utilize a group of individuals who do not have the outcome of interest (whatever is being measured) .Investigator then measures a number of variables that are relevant to the particular condition over a period of time (C J Mann, 2003). Cohort studies have multiple advantages which make them an attractive methodology for assessing risk. Research on risk factors is largely dependent on cohort studies based on ethical reasons, for instance people cannot be deliberately be exposed to cigarette smoke or asbestos for the purpose of research (C J Mann, 2003). Furthermore cohort studies enable investigators to examine multiple outcome variables. For instance the example cited earlier in case of smokers, researcher can simultaneously gauge information on death induced by from lung and cardiovascular disease. Cohort studies also provide clear understanding of causes and effect in its findings (D W North, 1995). Retrospective studies are very economic in nature; this is because the data has been collected previously however this at times reflects poorly on how rigorously the information was collected as it was originally gathered for some other purpose. Retrospective cohorts are also known to suffer from recall biases (C J Mann, 2003). In cases where two cohorts are compared it becomes extremely difficult to control for other factors that might differ between the two groups under study. These factors are known as confounding variables. However the role of confounding variables should not be over rated, prospective randomised controlled sampling can easily be utilized to eliminate all possibilities of confounding. On the other hand prospective cohort studies are limited in terms of following up, some sample/ cases may be lost during research which may affect the outcome. Other limitation of this method includes bias which again can occur in any research and any method of assessment hence Cohorts remain a very attractive risk assessment choice for environmental risks (D W North, 1995).Another very commonly used methodology is cross sectional studies .Cross sectional studies are primarily used for determining prevalence and to infer causation. Cross sectional studies are used to assess subject at one point in time to examine whether they are exposed to the relevant agent and to determine if they have an outcome of interest. Cross sectional studies are often used by market research firms for opinion polls. In cross sectional studies some of the subjects are without interest and exposure, this distinguishes cross sectional studies from various other observational studies. Cross sectional studies have numerous advantages to them. Data collected once can be used for multiple outcomes hence making it a relatively cheap.
Risk management today has become a vital part of our decision making process and our policy adoption. This is because risk assessment helps us improve process, make well informed decisions, create safe environment, improve people's perceptions about risk and create a positive outlook to life. The form of risk assessment which is in practice today follows the 'Red Book' paradigm, which was promulgated by the NRC in the year 1983. The Red Book acknowledged risk analysis as a formalized discipline and tool which contributed towards policy decision making and Implementations driven by scientific processes and quantitative rationale. However there is a growing popularity of the Orange Book paradigm for analysis of risk, demonstrating the new role of policy specialists in risk determination. This growing popularity of risk assessment however should not over shadow concerns such a difference of interest between general public and organizations and sometimes between public and government. There are also limitations such as time, recourses, availability of data and required skills. In the light of such limitations where there are many assessment methodologies available to assess risk, Cohort studies appear to be highly useful based on their ease of use, cost effectiveness and multi variable examination qualities.
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