Risk perception and communication - NMBU

Risk perception and

communicationYevgeniya Tomkiv

KJM360

Risk as number

Risk = Probability x consequences

• Deaths per million people

• Loss of life expectancy

Norwegian University of Life Sciences 3

The fundamental dilemma of

risk communication

The risks that kill people and the risks that alarm peopleare completely different

Covello & Sandman, 2001.

Norwegian University of Life SciencesTittel på presentasjon 5

What influences people’s

perceptions of different risks?

Characteristics of the hazard that

have an influence on Risk Perception

Fischhoff, et al., 1981

Acceptable Risks:

Voluntary

Under your control

Clearly beneficial

Fairly distributed

Natural

Statistical

From a reliable source

Familiar

Those that affect adults

Unacceptable risks:

Involuntary

Controlled by others

Of little or no benefit

Unfairly distributed

Man-made

Catastrophic

From unknown sources

Unfamiliar, exotic

Those that affect children

People are not irrational

Characteristics of the hazard that

have an influence on Risk Perception

Fischhoff, et al., 1981

Unacceptable risks:

Involuntary

Controlled by others

Of little or no benefit

Unfairly distributed

Man-made

Catastrophic

From unknown sources

Unfamiliar, exotic

Those that affect children

Additional factors -

Fukushima

• Nontransparent attitudes towards public from responsible

organizations and nuclear industry

• Lack of trust in government and experts

• Lack of communication

• Attention of media

• Uncertainty

Fukushima Challenges and Radiation Risk

Perception and Communication

• Tens of thousands died in the Fukushima earthquake, nearly half a

million were made homeless, yet since the accident most of the

focus has been on nuclear incident

• Reports of iodine tablets selling out in Europe

• More than 25 embassies closed or relocated from Tokyo

• Bans on import of foods from Japan

Fukushima Challenges

• 100,000 people haven’t returned home

• Increased stress

• Other effects like obesity

10

How do we deal with this?

Traditional media: Why?


• Media – main bridge for risk information from experts to

public

• Numerical information can be confusing

• Comparisons are more effective: but are they used and

how?

• Ongoing debate on how to present health risks

• Visual represention of risks

How should one communicate risk information to them?

Traditional media: How?


• Media content analysis

(N=1340)

• Articles related to the

Fukushima nuclear

accident

• In Belgium, Italy, Norway,

Russia, Slovenia, Spain.

• Published between the

11th of March - 11th of

May, 2011.

Analyzed:

• Radiation measurement unitsmSv (milli sievert)

mSv/h (millisievert per hour)

μSv/h (microsievert per hour)

nSV/h (nanosievert per hour)

Sv (Sievert)

Sv/h (Sievert per hour)

Bq/kg (Bequerel per kilogram)

Bq/g (Bequerel per gram)

Bq/l (Bequerel per litre)

kBq/kg (kilo Bequerel per kilogram)

MBq/kg (mega Bequerel per kilogram)

Bq/m2 (Bequerel per square meter)

Bq/cm2 (Bequerel per square centimetre)

kBq/cm2 (kilo Bequerel per square centimetre)

MBq/m2 (mega Bequerel per square metre)

MBq/km2 (mega Bequerel per square kilometre)

TBq/km2 (terra Bequerel per square kilometre)

no measurement units related to radioactivity in

the article

other units related to radiation

• Risk comparisons

no comparisons

with risks from medical purposes (e.g. x-ray)

with risks from flying

with natural radiation background

with workers' exposure to radiation at nuclear

inst.

with something else (open variable! )

with (legal,..) limits, norms

with a historic nuclear accident

• Visuals

Measurement units


32%

24%

15%

0%4% 2%

9% 8%

1% 0% 0%

37%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Perc

en

tag

e o

f art

icle

s

Type of unit

Percentage of unit type (all countries)

Total articles with units/all

articles

N = 211/1340

Comparisons

Available data

No explanation on

what they mean

Available data

Perceived

differently

Recommended

but not used

Health effects of radiation


“The radiation dose of 500,000

microsievert can cause dizziness

and fatigue after some hours. A dose

of 750,000 microsievert will cause

hair loss within to - three weeks

and a dose of one million will result

in bleedings. The deadly dose is 4

million microsieverts”

“… level which rose from 370 to

1,000 Becquerel per kilogram,

significantly increases the risk of

diseases such as cancer.”

“Since the beginning of the

crisis in the nuclear plant, 17

workers have been exposed to

more than 100 millisievert,

the level at which the risk of

getting cancer exists.”

• Health effects were rarely mentioned

• Detrimental health effects of high

doses rather than those relevant for

Japanese population

• Few mentioned cancer risks

Visuals


Dagsavisen,

17.03.2011

Corriere della Sera,

5.04.2011

Misrepresentations and

mistakes

• References to non-existing norms (e. g. levels in the enviroment)

• Using norms for drinking water as benchmark for seawater

• Mixing up allowed levels for general population and emergency

workers

• Mixing up dose and dose rate

• Presenting permitted levels as what divides

(food) into «safe» and «unsafe»


Conclusions

• Communication advice didn’t work – Why?

• Clear need of context, especially in the modern dynamic

media world

• Explain information that is hard to find (e.g. health effects)

• Importance of visual content

• Need to build relationships between experts and media in

the peace times

TOMKIV, Y., PERKO, T., OUGHTON, D., PREZELJ, I., CANTONE, M. C. & GALLEGO, E. 2016. How did

media present the radiation risks after the Fukushima accident: a content analysis of newspapers in Europe.

Journal of Radiological Protection, 36, S64.

PERKO, T., TOMKIV, Y., PREZELJ, I., CANTONE, M. C., GALLEGO, E. & OUGHTON, D. H. 2016. Communication with media in

nuclear or radiological emergencies: general and practical recommendations for improvement. Radioprotection, 51, S163-

S169.


KJM360: Societal and Ethical

Aspects of Risk Assessment

and Management

Deborah Oughton, NMBU

Psychosocial

Consequences

• “The social and psychological

consequences of Chernobyl far

outweigh any direct heath effects

from radiation exposure” (IAEA,

1991, + +)

• “The most important health effect is

on mental and social well-being,

related to the enormous impact of the

earthquake, tsunami and nuclear

accident, and the fear and stigma

related to the perceived risk of

exposure to ionizing radiation”

(UNSCEAR, 2013)

Public perception of risk

• ”Expert I” – the public is

ignorant, misunderstands

risks, is irrational in attitude

towards risks (smoke and

drive but rejects much

smaller risks associated with

GM foods, biotechnology,

nuclear power)

• ”Expert II” – the public’s

perception of risk is complex

(psychological, societal,

ethical, …)

Many factors influencing risk perception have

a strong ethical relevance

Oughton and Howard 2012. The Social and Ethical Challenges of Radiation Risk Management, Ethics, Policy and

Environment, 15:71-76; Oughton, D.H. 2011. Social and Ethical Issues in Environmental Risk Management.

Integrated Environmental Assessment and Management, 7: 404-405

Autonomy, Dignity, Control

• Control over situation

• Consent to risks

• Choice

• Participation in decision-making

Practical implications: self-help,

transparency about policy, stakeholder

engagement, personal dosimeters, local-

monitoring, …

Ethically and psychologically

importantLavrans Skuterud, NRPA

Justice, Fairness and Equity

• Distribution of risks and benefits

• Risks for children

• Differences between medical

(personal benefit) and environmental

exposures

• Practical Implications: Waste

disposal, time and spatial variation

in risk; compensation, cross boarder

issues

Photo: EPA




Well-being and Community Values

• Societal consequences of accidents

and risk management

• “Doing more good than harm”

• Fears of discrimination and stigma

• Importance of community and social

well-being (e.g. employment,

relationships, infrastructure)

Practical Implications: Remediation and

risk management needs to address more

than dose reduction; infrastructure,

“new-normality”




Social and Ethical Issues – Deborah Oughton

Other Factors Influencing

Radiation Risk Perception

• Natural vs unnatural sources

• Internal vs external exposure

• Identifiable vs statistical deaths

Harder to ground in ethical relevance

Evolution of the System of Radiological Protection:

Science, Ethical Values, and Experience

• Influence of scientific developments

• Influence of different applications – medical, energy,

accidents, …

• Influence of changes in societal and cultural

attitudes

29

ICRP TG94: The Ethical Foundations of the

ICRP System of Radiological Protection

• Beneficence/Non-maleficence

• Prudence

• Dignity

• Justice

30

Core Ethical Values Underpining the ICRP

System

Tools and proceduresfor the practical

implementation of the system

Radiological protection principles

Core ethical values underpinning the system of radiological protection

ICRP (2016) The Ethical Foundations of the ICRP System of Radiological Protection,

Draft out for consultation on icrp.org

Case Study – Thyroid Screening

• Prefecture wide screening – offered

to all 18 years old and under

• Baseline screening 2011-2104

–300,456 participants (81,7%)

• Full survey 2014-

• 169,455 participants (44,7%)

–113 suspicious or malignant

cases; 34 were operated on

(2015).

Reuters

Suzuki, 2016. Clinical Ontology; Shibuya et al. 2014, Lancet; Yasumura S, et al. Fukushima

Health Management Survey, 2012;

Background – Screening Results

Suzuki, 2016. Clinical Ontology; Shibuya et al. 2014, Lancet; Yasumura S, et al. Fukushima

Health Management Survey, 2012;

High Media and Academic Interest

Tsuda, et al. 2014: «An

excess of thyroid cancer has

been detected by ultrasound

among children and

adolescents in Fukushima

Prefecture within 4 years of

the release, and is unlikely to

be explained by a screening

surge” Epidemiology

Ethics of Health Screening and

SurveillanceThyroid Screening a text book case

• False positives/false negatives/overdiagnosis –

unnecessary surgery or worry

Carter et al. BMJ 2015;350

FOLKEHELSEVITENSKEP ETIKK –Deborah Oughton

Beneficence/Non-malificence

• Are we doing more good than harm?

• Will the procedure reduce incidence, severity or mortality

related to the disease?

• Overdiagonisis and unnecessary surgery

• Relieving or increasing anxiety?

• Highlights the complexity of balancing benefits and risks

“Health is a state of complete physical,

mental and social well-being and not

merely the absence of disease or infirmity”

(WHO, 1948)

Prudence

“Prudence is the ability to make informed and carefully

considered choices without the full knowledge of the scope

and consequences of actions” ICRP 2017, Ethical

Foundations….

• Links to precautionary approach

• Should not be taken to be synonymous with zero risk or

over conservatism

Thyroid Screening: Careful consideration of the

uncertainties and potential negative consequences of

surveillance and evaluation of measures to reduce negative

consequences

Justice

Distributive Justice - Fairness in the distribution of

advantages and disadvantages among groups of people

Restorative Justice – Fairness in compensation for losses

Procedual Justice – Fairness in the rules and procedures in

the processes of decision making

• Recognises vulnerability of children

• Selection of participants – location, not dose

• Screening for reassurance, epidemiology, research …

• Control groups

• Participation in decision making and screening planning

Dignity

• Survey (in part) responds to requests for screening

from parents – recognises their autonomy

• Free Informed Consent of children

• Stigma and discrimination – both from participation or

non-participation

• Provision of information to participants, pre, during and

post screening

• Privacy and confidentiality issues

Practical Aspects

Accountability:

– Clarification on responsibilities for screening, follow-

up, funding, …

Transparency

– Information to participants (initially by post, now

during consultation)

– Clarity on expectations and purpose of screening

– Communication strategy, including media, public

health officials

Stakeholder Participation

– Critical for success of screening

– Heath professionals, communities, parents, …

Stakeholder involvement

processes

Stakeholder

Anybody who can affect or is

affected by an organisation,

strategy or project


The process by which an

organisation involves people who

may be affected by the decisions it

it makes or can influence the

implementation of its decisions.



From Arnstein, Sherry R., "A Ladder of

Citizen Participation," Journal of the

American Institute of Planners, July

1969,Vol. 35, No. 4, pp. 216-224.



metods

Public hearing

Referenda

Consensus conference

Focus groups

Citizen jury

100++

• Representativeness

• Independence

• Early involvement

• Influence

• Transparency

Process: resource accessibility, task definition, structured

decision making and cost-effectiveness.



processes - Criteria

(Rowe and Frewer, 2000)

Accepta

nce

Is the evaluation of method

sufficient?

Does it show the quality of the process?

Case studies


Rogaland

County

Redeveloping criteria


Y. Tomkiv, A. Liland, D. Oughton, B. Wynne. Assessing quality of stakeholder

engagement: why methodology is not enough (to be submitted Spring 2017)

Representativeness

Independence

Early involvement

Influence

Transparency

Inclusiveness

Independence+Framing

Continuity and flexibility

Framing

Purpose and benefit

Accountability and learning

Made for policy-making – need adaptation

Too much focus on acceptance – process should be good!

(Rowe and Frewer, 2000)


Risk perception and communication - NMBU

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