Misreading hazards

Daily Telegraph Connected 13 March 1998 How we misread hazards

Daily Telegraph Connected 13 March 1998

Never has the world seemed such a dangerous place. On the road, at the doctors, or simply at home in the kitchen, a lethal combination of metal, microbes and simple circumstance now seem permanently out to get us.

At work, legislation becomes increasingly complex, litigation more savage, crime more sophisticated, and new technology usually throws up as many pitfalls as benefits. No wonder one of the more forward-thinking legal firms has recently established a specialist department to deal solely with “Millennium Risk”.

Yet all of us are expected to take decisions more quickly than ever before. Innovation, creativity and wealth generation always require risk, we are told, and to capitalise on opportunities, we must minimise the time spent on analysis. Technology should, and indeed does, improve the quality of life, but as science advances and as technological processes become increasingly complex, we are all worrying more, not less.

If staying in bed (what the pop psychologists call “analysis paralysis”) is not an option, we have to ask how to take risks intelligently. We also have to discover how to encourage others to measure risk accurately. And we have to decide how risk should sensibly be communicated to us.

Risk management has certainly advanced since the middle of the 17th Century when Blaise Pascal set the foundations of an intellectual revolution by proposing a theory of probability. Suddenly the likelihood that events would come to pass, or not, became the domain of the scientist rather than the soothsayer.

Simply because it is the greatest cause of ‘accidental’ death, road transport has been a prime subject for risk studies. It also has thrown up many of the obvious psychological complexities associated with risk-taking. As long ago as 1938 it was recognised that better brakes simply cause drivers to brake later and harder, and now the practical effects of ‘behavioural adaptation’ are well known. As more and more safety is designed into cars, and roads, most of us only drive faster and take greater risks.

Although the many competing motivations of the driver are now better recognised – the need to get there on time, the thrill of driving fast, the fear of a speeding ticket or social censure – the logical result is that protecting the driver from the consequences of bad driving only encourages bad driving. Thus, argue the extremists, the surest way of promoting safe driving is to ban seat belts and fix a large spike in the middle of the steering wheel pointing at the driver’s chest.

Dr Mayer Hillman, Senior Fellow Emeritus at the Policy Studies Institute, has been studying transport, health, environment and energy conservation issues for over 25 years. Some of his most startling work in the area of behavioural adaptation has concerned the wearing of cycle helmets.

Designed only to protect the head in the event of falling off a bicycle, and not to prevent injury in the event of collision with a motor vehicle, Hillman argues that a helmet is only worth wearing if cyclists are able to remind themselves constantly of this limited benefit. “If not, they are likely to ride with a false sense of security and, as a result, take less care and even ride marginally more dangerously,” he says.

In fact, logic suggests that road safety would be best served by all road users wearing helmets. Cyclists account for only 1 in 12 of road fatalities involving the sort of head injury for which a safety helmet offers some protection: nearly five times as many vehicle occupants and nearly five times as many pedestrians die as a result of head injuries as do cyclists. “Why not promote helmet wearing among the most vulnerable groups, pensioners?” Hillman mischievously enquiries.

The same logic suggests that children should wear helmets whilst playing, as research has shown that they are between two and three times as likely to suffer a head injury whilst climbing and jumping than as a result of a cycle accident.

Hillman’s recurring theme is the need for a holistic approach to risk assessment. “One cannot simply take transport safety as it is presently interpreted out of the total transport equation and deal with it in isolation,” he says. “At the level of personal decision making, we must establish whether minimising risk in one domain of lifestyle affects risk in others. There is a need to differentiate between the level of risk that people are prepared to take for themselves, and their children, and the level of risk they impose on others and on the environment.”

His examples are many and varied. He points to the fact that the advantages to the occupants of ‘safer’, ie. larger and heavier cars, is achieved at the expense of increased risk to pedestrians, cyclists, the occupants of lighter and smaller vehicles, and, indeed, the environmental well-being of the planet. Also that ‘protecting’ children by driving them around, instead of allowing them to travel on their own, increases the risk of damage to the physical and psychological development.

“Considerable confusion results from the way transport officials cite a reduction in the numbers killed and injured on the roads as an increase in ‘road safety’,” he says. “Road casualties are not a measure of road safety, and recognition of this is paramount to the evolution of sane and fair road safety policies.

“In the late 1980’s the Department of Transport claimed that ‘our roads are much safer’ quoting statistics showing that child road casualties had halved in the previous 20 years. In fact, one of the main reasons for this was a widespread public perception of a much less safe environment leading parents to impose ever greater restrictions on their children getting around on their own.”

What is possibly Hillman’s most radical study looked at the risks of cycling. The study, conducted for the British Medical Association, showed that there was a common denominator of ‘life years’ for both risk of death in cycle accidents and risk of death from lack of regular exercise.

By comparing the ratio between the two, he revealed that the number of life years gained through increased health resulting from cycling at least three times a week, exceeded the number of life years lost through cycle accidents by a factor of around 20 to 1, even in our current cycle hostile road environment.

“This was counter-intuitive and in some quarters an unpopular conclusion,” he says. “But the fact is that cycling is a unique way for the majority of the population to maintain its fitness from childhood through to old age because it can be tied into some of the daily routine of travel. For most people, the risk of not cycling is far greater than the risk of cycling.”

Developments in genetics and the recent health scares associated with food have moved the attention of risk researchers on from transport issues to broader aspects of public risk perception.

Psychologist Dr Lynn Frewer, a Senior Research Scientist at the Institute of Food Research, is well aware of muddled public perception of risk. “People tend to think that they are at less risk from domestic food poisoning than an average member of society,” she says. This means they tend to ignore advice about hygiene practice and do not take appropriate precautions.” This ‘optimistism bias’ is thought to be related to the need individuals have to feel that they are in control.

“We know that feelings of control reduce perceived risk. Driving is the classic example where people feel they are safer because they believe that they have more control than when they are on a bus or in an aeroplane, when in fact they are statistically more at risk. Similarly, lifestyle-related hazards, such as a high fat diet, also tend to be perceived as less risky than technology-related hazards, like pesticides, because people think they are in control over exposure to risks.”

The way most people think about risk is very different to technical risk estimates proposed by experts. Risk professionals frequently complain that non-experts are over-concerned with minor risks, and ignore major ones. Others argue that public perceptions are as valid as expert assessments.

Studies have shown, for example, that professional toxicologists have far lower perceptions of risk and more favourable attitudes towards chemicals than members of the public. Also worrying is the fact that male toxicologists, in particular, have been shown to be more likely to agree with the statement that chemical use is more likely to improve our health than harm it.

Regarding the public perception, Frewer turns to cars again. “The risks of driving are far greater than the risks associated with consuming food additives in normal quantities,” she says, “but many people actively avoid food additives, and do not think twice about using their cars. This is because people do not think of risk as a simple probability estimate. Also because they perceive specific benefits from using their cars.

“In the case of chemicals found in food, the public tends to focus on factors such as unfamiliarity, toxicity and whether their use is strictly necessary, as much as real risk to their health. The technological nature of modern food processing, pesticides, genetic engineering and so on also can lead people to overestimate risk. Part of this is lack of understanding, part of it lack of trust in those who are responsible for controlling the risk – science and the government.”

It is also significant that public perception of risk is weighted towards dramatic and memorable events. A major accident is likely to influence perception of risk for longer than would a less dramatic occurrence affecting an equal or greater number of people. Trust in risk regulators is an important part of risk perception, and catastrophic events amplify public perceptions that the hazard is out of control.

With Bhopal, Three Mile Island and Chernobyl etched on our collective consciousness, and the muddle over BSE and ‘Mad Cow’ disease an ever-present cloud, the regulators certainly need to do something to win back our trust. But it will be hard work. Never has society been so sceptical about the trustworthiness of its political and economic leaders.

So out goes the old idea that risk communication is simply a matter of experts needing to convince a doubting public, and in comes a new broom advocating reciprocal communications between the public and the experts to derive solutions acceptable to everyone. But that doesn’t mean the experts know everything, or know best.

Lynn Frewer sums it up. “It is essential that risk communications take account of what the public wants to know about a particular hazard as well as technical risk information,” she says. “With genetic engineering, for example, public concern focuses on ethical issues, perceptions of unnaturalness and whether the technology is necessary. These concerns are more complex than simply questions of whether there is any risk attached to the application and development of the technology and must be addressed.”

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