Risk Analysis in the 21st Century: Adapting to New Challenges and Opportunities

During the late 1970s, there was widespread concern that many chemicals in commerce caused cancer or promoted it. In addition, the US government was concerned about operations of commercial nuclear power plants, which at that time seemed destined to increase from approximately 100 plants to 10 times that number. Hazardous waste disposal was a third widely publicized national human health and environmental issue. In response to these concerns, the US government charged the newly created Environmental Protection Agency (EPA) and the Nuclear Regulatory Commission (NRC) with developing a scientific basis for assessing and managing associated risks.^1,2

In response, a group of primarily scientists and engineers developed the Society for Risk Analysis (SRA). The SRA quickly expanded to include members from Europe, Asia, and selected other nations. The following 6 questions are a convenient way of presenting how risk analysts study a possible threat; the first 3 cover risk assessment, and the last 3 cover risk management¹:

1. What can go wrong?

2. What are the chances that something with important consequences will go wrong?

3. What are the consequences if something does go wrong?

4. How can consequences be prevented or reduced?

5. How can recovery be enhanced if the event occurs?

6. How can key local officials, expert staff, and the public organize and be informed to reduce risk and concern, and increase trust and confidence?

These six questions represent the systematic approach of risk analysis, covering ecological health, and the social, political, legal, and economic consequences of risks and their management. They became core elements of risk analysis as the field matured, with epidemiologists, toxicologists, and engineers, as well as sociologists, anthropologists, ethicists, economists, and psychologists broadening SRA membership.

The aerospace, medical, military, oil, and rail industries have become heavily vested in risk analysis. Recently, the fields of oral health and criminal justice have begun to apply the tools of risk analysis. Despite having some limitations, the field has carved out an important niche, providing scientifically based information about human health and environmental risk to decision-makers.

BIG DATA APPLICATIONS TO CUMULATIVE RISK

I have worked on many risk analyses, and the frustration I face is not having enough high-quality data. Sometimes, no data are available for analysis, and best estimates rely on professional judgement. Other times, data might be available, but it might not be representative of the problem being studied. This issue is addressed in this issue of AJPH by Gwinn et al.³ (p. 1032) and nine other current or former EPA employees. Their article describes how risk assessment will be expanded in the 21st century by increased monitoring in multiple environments, storing the data in formats that are compatible with other data sets, and widely circulating these data. The data can then be used to investigate complex multifactor hypotheses about the contribution of chemical risks to disease.

The Gwinn et al.³ approach allows for the formulation of models that simulate multiexposure environments rather than the current set of analytical tools that examine one chemical at a time. The authors assert that using big data to explore cumulative risk may lead to the reduction of environmental exposures from multiple chemical agents and nonchemical stressors. They provide the example of heart disease, and identify specific organ targets and genetic expressions that need further exploration. Their approach is clearly applicable to the exploration of other complex health outcomes (e.g., children’s behavioral disorders or obesity).

The big data approach faces challenges, particularly in removing traditional turf and legal barriers that exist between agencies and their subunits that maintain data sets. We must overcome these issues if we are to adopt a new paradigm that presents a holistic view of health and disease. I firmly believe this can be done, because it already has already been done in other branches of science.

SYSTEMS MODELING AND CUMULATIVE RISK

Understanding relationships among behavioral, environmental, and social risk factors requires sophisticated systems modeling that link these factors with health outcomes and each other. Risk analysts have a long history of such efforts in regard to asbestos, mercury, radiation, and many others toxins.^1,2 What is exciting today is that the promise of big data will allow us to build stronger models based on many more factors that influence outcomes than were available in the past.

CUMULATIVE RISK AND ENVIRONMENTAL JUSTICE

Neither cumulative risk nor systems thinking are new to this Journal. I found more than two dozen articles about cumulative risk and systems in the Journal, many of which are recent. What is different about the article by Gwinn et al. is that it lays out a plan for using big data to make progress in our understanding of multiple risks. Having served on an EPA Environmental Justice Science Advisory Board committee and having studied cumulative risk and environmental justice for many years, I believe that the ideas in this article are implementable at this time, not across the entire nation, but in selected neighborhoods. The place to try out database development, intersection, and modeling of human health impacts is in neighborhoods with concentrations of industry, warehousing, and transportation.

For instance, Newark, New Jersey, has neighborhoods with populations that are more than 80% African American and Latino American, and who are disproportionately poor. Newark passed the first environmental justice ordinance that we are aware of in the United States. The ordinance requires applicants for a new site to provide data about their proposals for local review.⁴ However, for the ordinance to work, this city and many others like it across the United States need technical support that logically should come from federal and state environmental protection agencies. Will they get it? I am doubtful because of proposed budget cuts and other constraints placed on the EPA.^5,6 From the perspective of environmental and social justice, to postpone or even repudiate these important potentially path-breaking opportunities would be a serious miscarriage of social justice.