Environmental Health Sciences Decision Making Risk Management, Evidence, and Ethics: Workshop Summary (2009) / Chapter Skim
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2 Scientific Issues in Environmental Health Decision Making
2 Scientific Issues in Environmental Health Decision Making
Pages 21-34
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From page 21... ...
There will always be new information to consider once a decision is made, which in some instances may alter the landscape for making decisions based on science. This chapter captured the presentations and discussion on how to weigh evidence in decision making, working with variability and uncertainty in the data, the use and misuse of science in decision making, and when policy makers should revisit decisions based on advancing science.
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From page 22... ...
The forms of evidence include biochemical data, animal studies, population studies, and individual studies. The standards of evidence relate to such issues as the consistency, strength, specificity, response of the association, and the biological plausibility.
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From page 23... ...
There is also a spectrum of factors at work in the decision making for population health, but that spectrum relates to the nature of the intervention -- with purely environmental interventions at one pole (e.g., water supply fluoridation) and purely individual interventions at the other (e.g., behavioral change interventions designed to encourage smoking cessation, increased physical activity, a change in dietary habits)
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From page 24... ...
Perhaps the most important commonality related to the interpretation of evidence in both clinical and population health settings is the centrality of effective communication. Too often the concept of risk communication is not well understood, yet the ability to explain the nature of risk and the evolving nature of the scientific process is vital to enabling the public to understand how decisions are made in a scientific context.
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From page 25... ...
In a priority-setting system, greater uncertainty in priority scores suggests greater spreading of resources to lower scoring categories or interventions. Essentially, better data on lower priority categories improve information for later decision making, and the value of that information is greater if there is greater uncertainty initially.
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From page 26... ...
While current practice does allow for susceptible subgroups with a defined safety threshold, there is no single factor that can capture a distributional response. Therefore, what is needed and obtained by using best practice is the quantitative analysis of how many people and which groups of people are at how much risk from various policies -- ideally with some statement of associated confidence (Hattis, 2004)
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From page 27... ...
First, legal cases involving environmental issues are increasingly calling for the recognition that some finite rates of adverse effects will remain even after implementation of reasonably feasible control measures. Second, societal reverence for life and health means making the best decision with available resources to reduce harmful effects.
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From page 28... ...
In the environmental field, this analysis often involves applying evidence from chemical structures and animal studies to human epidemiological evidence. Data are collected and reviewed by a multidisciplinary team of subject matter experts, who, after taking into account confounding factors and scientific error, try to reach a consensus on a particular scientific issue, which may then be accepted by the larger scientific community and the public.
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From page 29... ...
Second is which specific exposures should be studied and what are the best testing systems. One way the NTP has approached this is through the creation of the Interagency Coordinating Committee on Validation of Alternative Methods, which "promotes the scientific validation and regulatory acceptance of toxicological test methods that more
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From page 30... ...
Report on Carcinogens: Criteria and Process for Listing The Report on Carcinogens (RoC) is a congressionally mandated document "prepared by the NTP for the purpose of identifying substances, mixtures of chemicals, or exposure circumstances associated with technological processes that cause or might cause cancer and to which a significant number of persons in the United States are exposed.
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From page 31... ...
Two other important changes to the RoC are a change in publication times, from annually to every 2 years, and the decision to use all of the available science as the criteria for inclusion in the report -- for example, the allowance for the utilization of knowledge of mechanisms and structure/activity relationships in assessing risk. This change provided a set of criteria to determine that if a chemical or substance has a structure or activity comparable to a chemical already listed in the report, it is reasonable to assume that the chemical in question would also be a known or reasonably anticipated human carcinogen, even if all of the data needed to draw such a conclusion are still not accessible.
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From page 32... ...
. Third, results of several human epidemiological studies showed no clear association between saccharin consumption and urinary bladder cancer in the general population compared with diabetics, who presumably consume greater amounts of artificial sweeteners (Armstrong and Doll, 1975)
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From page 33... ...
Explaining the scientific process may include applying different standards of proof in legal settings, so that the expresson of uncertainty by a scientist does not mean the end of a case or does not become fodder for the opposing side. One possible solution to the growing question of scientific uncertainty and the disconnect between the scientific and legal processes is that of transparency and communication, noted McGinnis.
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