Transcript comparative risk assessment a tool for setting priorities

COMPARATIVE RISK ASSESSMENT:
SETTING PRIORITIES FOR URBAN
ENVIRONMENTAL MANAGEMENT IN
DEVELOPING COUNTRIES
Presentation by Barbara Britton
January 18, 2000
OUTLINE OF PRESENTATION
Part I
Introduction and Background
Part II
International Experience with CRA
Part III Methodology
PART I: INTRODUCTION
AND BACKGROUND
HISTORY OF COMPARATIVE
RISK ASSESSMENT
First used in the U.S. in 1987
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“Unfinished Business” evaluated 31 problems and
changed USEPA priorities
Many projects completed for regions, states, and cities
Used outside the U.S. by USAID and USEPA
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First assessment was in Bangkok, 1990
Assessments completed for about 10 cities and regions
What DID EPA Learn From
Comparative Risk Efforts?

Chemical-Specific, Media-Specific,
Technology-Based Approaches have
Limitations

Policies Based on Comparative Risk
Assessments Could Lead to More Efficient
Use of Resources and Greater Protection of
Public Health and the Environment
ENVIRONMENTAL
MANAGEMENT
Comparative Health Risk Assessment is used to set
priorities for environmental management.
Risk Assessment
Identify and evaluate
risks, set priorities
among problems.
Risk Management
Develop and
implement solutions for
high priority problems
ENVIRONMENTAL RISKS
Environmental damage may have three types of negative effects.
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Public Health--illness, injuries, deaths
Ecological--loss of species and habitat
Quality of Life--economic and social costs
TYPES OF “RISK ASSESSMENT”
Health Risk Assessment:
evaluates the potential public health impacts of
an environmental condition
Comparative Health Risk Assessment:
evaluates and compares the potential health
impacts of several environmental conditions
Comparative Risk Assessment:
evaluates and compares the potential health,
ecological, and quality-of-life impacts of
several environmental conditions
PART II: INTERNATIONAL
EXPERIENCE WITH
COMPARATIVE RISK
ASSESSMENT
International Experience With
Comparative Risk Assessment
Bangkok: Accelerated plans for banning lead in gasoline
Cairo: USAID projects to reduce air pollution and lead contamination
Ahmedabad: Municipal program to reduce air pollution from transport
Lima: USAID environmental health project under design
Silesia: USAID technical assistance to high risk industrial facilities
“HIGH RISK” PROBLEMS
FROM FIVE CRAs
Environmental Problem
Categories
Bangkok
Quito
Cairo
Water, Sanitation, or
Microbial Diseases
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Ambient PM
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Indoor Air
Lead
Air Pollution from Transport
Solid Waste
Ahmedabad
Lima
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CRA RESULTS: BANGKOK
Bangkok, Thailand (1990)
High
Airborne Particulate Matter
Lead Contamination
Microbiological Diseases
Moderate
Carbon Monoxide (CO)
Other Metals
Low
Toxic Air Pollutants
Other Gaseous Air Pollutants (SO2, NO2, O3)
Surface Water Contamination
Ground Water Contamination
Pesticides & Metals in Food
Solid & Hazardous Wastes
CRA RESULTS: CAIRO
Cairo, Egypt (1994)
High
Moderate
Airborne Particulate Matter
Lead (all media)
Microbiological Diseases
Microbiological Contamination of Food
Ozone
Other Gaseous Air Pollutants (SO2, CO)
Moderate/Low
Low
Indoor Air Pollution
Drinking Water (microbes, chemicals)
Solid and Hazardous Wastes
Toxic Air Pollutants
Other Water Pathways (e.g. fish, irrigation)
CRA RESULTS: AHMEDABAD
Ahmedabad, India (1995)
High
Air Pollution from Mobile Sources
Ambient Air Pollution (all sources)
Indoor Air Pollution
Moderate
Drinking Water
Wastewater
Low
Occupational Hazards
Traffic Hazards
Food Contamination
CRA RESULTS: LIMA
Lima, Peru (1997)
High
Inadequate Water Supply
Inadequate Sanitation
Solid Waste
Moderate
Surface and Groundwater Contamination
Food Contamination
Air Pollution
Water Pollution (marine)
Low
Hazardous Waste
Toxic Substances
Indoor Air Pollution
Loss of Landscaped Areas & Farm Land
PART III: COMPARATIVE
RISK ASSESSMENT
METHODOLOGY
STEPS IN RISK ASSESSMENT
Health risk assessment is quantitative, based on
experimental and observational data.
Hazard Identification-identify health risks associated with exposure
Dose-Response Assessment-model the relationship between dose and effects
Exposure Assessment-estimate a group’s exposure (amount, duration)
Risk Characterization-estimate the probability and severity of effects
CONCEPTUAL MODEL LINKING
ENVIRONMENTAL CONDITIONS AND
HEALTH
Source
Discharge
Transport and Fate
in the Environment
Transport and Fate
in the Body
Dose Target Organs
Exposure
Damage, Disease, or Death
Intake
EXAMPLE:
HEALTH RISK ASSESSMENT
Health Risk Assessment in Bangkok:
Population:
5.9 million
Airborne particulates:
90 - 200 g/m3
Health effects (per year):
 9 - 51 million restricted activity days
 300 - 1400 deaths
EXAMPLE:
HEALTH RISK ASSESSMENT
Health Risk Assessment in Quito, Ecuador:
Population:
1.1 million
Pesticides in food:
44.3 g/day intake of heptachlor
11.0 g/day intake of aldrin
Health Effects:
0.3 to 9.1 x 10-3 lifetime cancer risk
Up to 150 excess cancer cases/year
EXAMPLE: COMPARATIVE
HEALTH RISK ASSESSMENT
Quito, Ecuador (1993)
Risk
Metropolitan Area
High
Microbiological Diseases (Food)
Airborne Particulate Matter
Microbiological Diseases (Food)
Airborne Particulate Matter
Indoor Air Quality
Occupational Disease and Injuries
Drinking Water and Wastewater
Traffic Injuries
Drinking Water and Wastewater
Indoor Air Quality
Occupational Disease and Injuries
Traffic Injuries
Solid & Hazardous Waste Disposal
Solid & Hazardous Waste Disposal
Pesticides in Food
Pesticides in Food
Moderate
Low
Asentamientos Populares
CRA METHODOLOGY
Four Phases of Comparative Risk Assessment
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Planning
 Determine scope of the study
 Select and organize the team
 Identify data types and sources
Data Collection and Analysis
 Identify and gather data
 Analyze data to estimate risks
Priority Setting
 Interpret and compare risks
 Debate and agree on priorities
Reporting
 Prepare report as input to risk management planning
FUNCTIONS AND RESPONSIBILITIES
The organization of
a CRA must address
five necessary
functions:
Function
Typical Unit
Project Management and
oversight
Project Manager
Policy direction and
project mandate
Steering Committee
Public participation
Public Advisory Committee
Final risk ranking
Steering Committee or
Public Advisory
Committee
Technical Committees
Technical analysis--data
collection, risk assessment,
preliminary ranking
PARTICIPATORY ASPECTS OF
CRAs
Broad participation is critical because:
•Analysis is multi-disciplinary and highly complex
•Setting priorities are ultimately based on values
of the community
•Broad participation is linked to acceptance of
CRA results and implementation of actions to
reduce risks
TECHNICAL ANALYSIS
Identify and evaluate health impacts of many
environmental conditions
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water and food
sanitation, drainage, and wastewater
ambient and indoor air, gases and particles
solid and hazardous wastes
occupational injuries and exposures
infectious, vector-borne, and pollutant-related diseases
ADAPTING TECHNICAL ANALYSIS FOR
CRA IN DEVELOPING COUNTRIES
ISSUE
RESPONSE
Scope includes infectious
diseases, outside traditional risk
assessment methods
Use health data from clinics
and local survey to estimate
disease rates.
Limited information and many
data gaps.
Use environmental, health, and
qualitative data
Data are not computerized and
are aggregated at inappropriate
geographic levels.
Reorganize information; use
assumptions and extrapolation
where necessary.
Some standard exposure
assumptions are inappropriate
due to culture or conditions.
Adjust assumptions; conduct
special studies if possible.
PRIORITY SETTING
Categorize each health impact by magnitude and
severity
magnitude -- number of people affected
severity -- of effect, and importance of group affected
Combine magnitude and severity scores
Compare and categorize environmental problems
high, medium, and low risk
CRA Risk Ranking
Risk ranking requires judgments based on values
Comparing health effects:
acute vs. chronic
disease vs accidents
Comparing effects among groups:
children vs. working adults vs. elderly
poor vs. middle income
voluntarily exposed vs. involuntary exposed
women vs. men
Conclusion
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CRA’s can form an effective basis for urban
environmental management planning
Allow cities to address worst environmental
problems first
Broad-based participation is crucial to ensure risk
ranking reflects views of entire community
Stakeholder involvement is pivotal to ensuring
risk assessment results translate into management
action