Institute for Research in Extramural MedicineInstitute for Research in Extramural Medicinevrijevrije Universiteit Universiteit AmsterdamAmsterdam

Risk perception and Risk perception and

risk communication risk communication

in occupational healthin occupational health

Tjabe SmidTjabe Smid

KLM health safety & environmentKLM health safety & environment

EMGO-Institute Free University AmsterdamEMGO-Institute Free University Amsterdam

Personal experiencePersonal experience

• As occupational and radiation hygienist, As occupational and radiation hygienist, • As safety advisor,As safety advisor,• In advising on environmental noise and safety (in a In advising on environmental noise and safety (in a

‘political’ arena),‘political’ arena),• In teaching HSE issues to students,In teaching HSE issues to students,• In research on prevention of back pain,In research on prevention of back pain,• As project leader in a study into health complaints As project leader in a study into health complaints

among workers involved in salvage and cleanup after among workers involved in salvage and cleanup after an airplane crash.an airplane crash.

ProgramProgram

I. Why is risk communication increasingly important?I. Why is risk communication increasingly important?

II. Risk perceptionII. Risk perception

III. Risk communicationIII. Risk communication

IV. Lessons (to be?) learnedIV. Lessons (to be?) learned

I. Why risk communication is I. Why risk communication is importantimportant

• Increasing job demands and productivityIncreasing job demands and productivity -> potentially conflicting with safety goals-> potentially conflicting with safety goals• Increasing personal responsibilities through Increasing personal responsibilities through

empowerment empowerment • Perceived risk is more importantPerceived risk is more important• Less chemical and physical hazardsLess chemical and physical hazards -> stress-related influences are more -> stress-related influences are more

importantimportant

Example:Example:Post …. syndromesPost …. syndromes

• After major disasters, war, etcetera After major disasters, war, etcetera • With marginal chemical/physical riskWith marginal chemical/physical risk• Many health complaints Many health complaints

• Functional somatic syndromes:Functional somatic syndromes:– General, diffuse, common symptomsGeneral, diffuse, common symptoms– Explicit self-diagnosesExplicit self-diagnoses

• Comparable to SBS, multiple chemical sensitivityComparable to SBS, multiple chemical sensitivity

Functional somatic syndromesFunctional somatic syndromes

• Symptoms somatic and psychologicalSymptoms somatic and psychological• Fatigue, weakness, headache, sleep disturbances, Fatigue, weakness, headache, sleep disturbances,

musculoskeletal, gastro-intestinal, skin complaints, respiratory musculoskeletal, gastro-intestinal, skin complaints, respiratory problems, fear and anxiety, depressionproblems, fear and anxiety, depression

• Related to disaster AND AFTERMATHRelated to disaster AND AFTERMATH

• Mechanism: general symptoms attributed to disasterMechanism: general symptoms attributed to disaster• Or stress -> central nervous system effect -> immunologic Or stress -> central nervous system effect -> immunologic

effectseffects

• Communication is crucial!Communication is crucial!

ProgramProgram

I. Why is risk communication increasingly important?I. Why is risk communication increasingly important?

II. II. Risk perceptionRisk perception

III. Risk communicationIII. Risk communication

IV. Lessons (to be?) learnedIV. Lessons (to be?) learned

II. Risk perceptionII. Risk perception

• Experts and the public (workers) differ in their Experts and the public (workers) differ in their perception of riskperception of risk

• Experts try to evaluate risk using:Experts try to evaluate risk using:– Numbers and statisticsNumbers and statistics– Relative rankingRelative ranking

• The public (workers) evaluate and ranks risk The public (workers) evaluate and ranks risk intuitivelyintuitively

• But there are patterns in risk perceptionBut there are patterns in risk perception

Intuition overestimates risk when:Intuition overestimates risk when:

1.1. The effect is larger (especially catastrophic)The effect is larger (especially catastrophic)

2.2. Exposure is not voluntarilyExposure is not voluntarily

3.3. Risk/effect is lesser knownRisk/effect is lesser known

4.4. Sensory perception is difficultSensory perception is difficult

5.5. There is less personal controlThere is less personal control

6.6. Effects are long-termEffects are long-term

7.7. Risk is man-madeRisk is man-made

8.8. Previous incidents have happened, (with victim identity)Previous incidents have happened, (with victim identity)

9.9. Experts are not consistentExperts are not consistent

10.10. There is less confidence in people in controlThere is less confidence in people in control

11.11. There is more media attentionThere is more media attention

1. Larger effects1. Larger effects

• The risk of large scale accidents and catastrophes The risk of large scale accidents and catastrophes is overestimated (plane vs. car accidents)is overestimated (plane vs. car accidents)

• And large scale accidents appear to have more And large scale accidents appear to have more psychological impactpsychological impact

2. Voluntary risks2. Voluntary risks

• Voluntary risks are underestimatedVoluntary risks are underestimated• This factor may explain (among others) why workers This factor may explain (among others) why workers

don’t wear PPD when it is not compulsorydon’t wear PPD when it is not compulsory

3. Risk is less known3. Risk is less known

• Unfamiliar risk is overestimated Unfamiliar risk is overestimated • I.e. chemical risk is considered more severe than I.e. chemical risk is considered more severe than

example falling, or back injuriesexample falling, or back injuries

4. Sensory perception4. Sensory perception

• Difficult sensory perception leads to overestimation of risk

• Because you have to rely on others for information• I.e. radiation, or (odourless and invisible) asbestos

fibers in air

5. Less personal control5. Less personal control

• Relates to 2. (voluntary risk) Relates to 2. (voluntary risk) • Perceived control leads to a less severe risk Perceived control leads to a less severe risk

perceptionperception• 80 % of the Dutch consider their driving above 80 % of the Dutch consider their driving above

averageaverage

6. Long term effects6. Long term effects

• Workers are more afraid of long term health effects, Workers are more afraid of long term health effects, than of short term effectsthan of short term effects

7. Man made risk7. Man made risk

• Man made risks (chemical, nuclear) are perceived Man made risks (chemical, nuclear) are perceived more severe than for example lightning, storm, or more severe than for example lightning, storm, or floodingflooding

8. Previous accidents8. Previous accidents

• Especially when there is victim identityEspecially when there is victim identity• Victim identity can be brought through mediaVictim identity can be brought through media

9. Experts are not consistent9. Experts are not consistent

• Or not perceived consistentOr not perceived consistent• Internet information is also considered expert opinionInternet information is also considered expert opinion

10 Less confidence in people 10 Less confidence in people responsible for control and responsible for control and

informationinformation

• Especially when risk is not familiar, not known, not Especially when risk is not familiar, not known, not sensory perceived, people have to rely on others for sensory perceived, people have to rely on others for their informationtheir information

11. Media attention11. Media attention

• Last but not least!Last but not least!

ExamplesExamples

1999: KLM has transported a package of nuclear medical material. The package leaked small amounts of radioactive radiation. The maximum estimated dose for crew was 1 % of the total allowed annual dose. The shipper reported it two months later, and simultaneously it was published in national newspapers and television. Workers (and passengers) were very upset about this (in terms of radiation) minor incident, and it lead to a total ban on radioactive cargo

Vs. the most recent deadly accident in KLM ground staff was around 1985, when a worker fell from a platform in maintenance. Falls occur more often, are are considered a major risk by safety experts

Radiation incidentRadiation incident

1.1. The effect is larger (especially catastrophic) -The effect is larger (especially catastrophic) -

2.2. Exposure is not voluntarily ++Exposure is not voluntarily ++

3.3. Risk/effect is lesser known +Risk/effect is lesser known +

4.4. Sensory perception is difficult +++Sensory perception is difficult +++

5.5. There is less personal control ++There is less personal control ++

6.6. Effects are long-term +++Effects are long-term +++

7.7. Risk is man-made +++Risk is man-made +++

8.8. Previous incidents have happened, (with victim identity) +/-Previous incidents have happened, (with victim identity) +/-

9.9. Experts are not consistent + (internet)Experts are not consistent + (internet)

10.10. There is less confidence in people in control ++ (2 months lag)There is less confidence in people in control ++ (2 months lag)

11.11. There is more media attention ++++There is more media attention ++++

Falls in maintenanceFalls in maintenance

1.1. The effect is larger (especially catastrophic) + / - -The effect is larger (especially catastrophic) + / - -

2.2. Exposure is not voluntarily - / +Exposure is not voluntarily - / +

3.3. Risk/effect is lesser known - - -Risk/effect is lesser known - - -

4.4. Sensory perception is difficult - Sensory perception is difficult -

5.5. There is less personal control - - -There is less personal control - - -

6.6. Effects are long-term - - -Effects are long-term - - -

7.7. Risk is man-made -/+Risk is man-made -/+

8.8. Previous incidents have happened, (with victim identity) +Previous incidents have happened, (with victim identity) +

9.9. Experts are not consistent - - -Experts are not consistent - - -

10.10. There is less confidence in people in control - -There is less confidence in people in control - -

11.11. There is more media attention - - -There is more media attention - - -

ProgramProgram

I. Why is risk communication increasingly important?I. Why is risk communication increasingly important?

II. Risk perceptionII. Risk perception

III. III. Risk communicationRisk communication

IV. Lessons (to be?) learnedIV. Lessons (to be?) learned

III. Risk communicationIII. Risk communication

There is no standard risk communication !There is no standard risk communication !

Risk communication Risk communication

1.1. Know your target group(s)Know your target group(s)

2.2. Know your goalKnow your goal

3.3. Know the expectationsKnow the expectations

4.4. Be trustworthyBe trustworthy

5.5. The message should be unequivocalThe message should be unequivocal

6.6. Be timelyBe timely

7.7. Be open and transparentBe open and transparent

8.8. Be consistentBe consistent

9.9. Keep the initiativeKeep the initiative

1. Know your target group1. Know your target group

• I.e. – Workers involved

• Victims

• Others

– Uninvolved workers– Their representatives– Their management– Third parties (among others media)

2. Know your goal2. Know your goal

• May be different for different target groupsMay be different for different target groups• Transfer of information is not the goalTransfer of information is not the goal• But is used for for example:But is used for for example:

– Safe behaviourSafe behaviour– Prevention of stress: reassurancePrevention of stress: reassurance– ComplianceCompliance– Prevention of reliabilityPrevention of reliability

Know your goal (2)Know your goal (2)

• KnowledgeKnowledge• SkillsSkills• AttitudesAttitudes• BehaviourBehaviour

3. Know the expectations3. Know the expectations

• What, how, when does the target group needs What, how, when does the target group needs informationinformation

• Consider perception, cultureConsider perception, culture• I.e. symptoms are somatic in Functional somatic I.e. symptoms are somatic in Functional somatic

syndromessyndromes• Know your role as perceived by the target groupKnow your role as perceived by the target group

4. Be trustworthy 4. Be trustworthy

• Workers know about risk from othersWorkers know about risk from others• The criterion is confidence rather then ratioThe criterion is confidence rather then ratio• External factors are yourExternal factors are your

– PositionPosition– AgeAge– GenderGender

5. The message should be 5. The message should be unequivocalunequivocal

• Not Not tootoo many details many details• Emphasize what is knownEmphasize what is known• Coordinate different speakersCoordinate different speakers• Know that your perception of competence may differ Know that your perception of competence may differ

from that of your target group (‘The American from that of your target group (‘The American professor’)professor’)

6/7/8. Be timely, consistent and 6/7/8. Be timely, consistent and transparenttransparent

• Total transparency and openness Total transparency and openness • Is not a goal but instrumentalIs not a goal but instrumental• Example: asbestos in buildingsExample: asbestos in buildings• Never keep something ‘under the hat’ that may Never keep something ‘under the hat’ that may

escapeescape

9. Keep the initiative9. Keep the initiative

• By keeping the initiative, the agenda can be setBy keeping the initiative, the agenda can be set• Latent disturbances can evolve any momentLatent disturbances can evolve any moment

ProgramProgram

I. Why is risk communication increasingly important?I. Why is risk communication increasingly important?

II. Risk perceptionII. Risk perception

III. Risk communicationIII. Risk communication

IV. IV. Lessons (to be?) learnedLessons (to be?) learned

IV Lessons (to be) learnedIV Lessons (to be) learned

• Risk perception shows a consistent patternRisk perception shows a consistent pattern• Recognition of this phenomenon among professionals is Recognition of this phenomenon among professionals is

marginalmarginal• But individuals may be very different from each other.But individuals may be very different from each other.• Knowing the perspective of the worker is very important (on your Knowing the perspective of the worker is very important (on your

role an contents of the message)role an contents of the message)• There is more then an expert role for professionalsThere is more then an expert role for professionals• After incidents: give information on causes and circumstancesAfter incidents: give information on causes and circumstances• Take health complaints seriousTake health complaints serious• Communicate on group level, but also on individual levelCommunicate on group level, but also on individual level

Thank you.Thank you.Any questions?Any questions?