Evaluating the Reliability of Emergency Response Systems for Large-Scale Incident Operations.

The ability to measure emergency preparedness-to predict the likely performance of emergency response systems in future events-is critical for policy analysis in homeland security. Yet it remains difficult to know how prepared a response system is to deal with large-scale incidents, whether it be a natural disaster, terrorist attack, or industrial or transportation accident. This research draws on the fields of systems analysis and engineering to apply the concept of system reliability to the evaluation of emergency response systems. The authors describe a method for modeling an emergency response system; identifying how individual parts of the system might fail; and assessing the likelihood of each failure and the severity of its effects on the overall response effort. The authors walk the reader through two applications of this method: a simplified example in which responders must deliver medical treatment to a certain number of people in a specified time window, and a more complex scenario involving the release of chlorine gas. The authors also describe an exploratory analysis in which they parsed a set of after-action reports describing real-world incidents, to demonstrate how this method can be used to quantitatively analyze data on past response performance. The authors conclude with a discussion of how this method of measuring emergency response system reliability could inform policy discussion of emergency preparedness, how system reliability might be improved, and the costs of doing so.

Federal initiative increases community preparedness for public health emergencies.

Policy makers need to know whether federal programs can improve community-level readiness for large-scale public health emergencies, and how to design such programs to increase their impact. This article describes an evaluation of the Cities Readiness Initiative, a federal program to improve communities' ability to dispense medications rapidly during emergencies. The program helped increase staffing, improve planning and partnerships, and streamline medication-dispensing procedures. The evaluation results indicate that clear goals, technical assistance, and a balance between threat-specific and more-general "all hazards" planning might improve the effectiveness of federal readiness programs.

Developing national standards for public health emergency preparedness with a limited evidence base.

OBJECTIVE: The paucity of evidence and wide variation among communities creates challenges for developing congressionally mandated national performance standards for public health preparedness. Using countermeasure dispensing as an example, we present an approach for developing standards that balances national uniformity and local flexibility, consistent with the quality of evidence available. METHODS: We used multiple methods, including a survey of community practices, mathematical modeling, and expert panel discussion. RESULTS: The article presents recommended dispensing standards, along with a general framework that can be used to analyze tradeoffs involved in developing other preparedness standards. CONCLUSIONS: Standards can be developed using existing evidence, but would be helped immensely by a stronger evidence base.

Prioritizing environmental health risks in the UAE.

This article presents the results of a comparative environmental risk-ranking exercise that was conducted in the United Arab Emirates (UAE) to inform a strategic planning process led by the Environment Agency-Abu Dhabi (EAD). It represents the first national-level application of a deliberative method for comparative risk ranking first published in this journal. The deliberative method involves a five-stage process that includes quantitative risk assessment by experts and deliberations by groups of stakeholders. The project reported in this article considered 14 categories of environmental risks to health identified through discussions with EAD staff: ambient and indoor air pollution; drinking water contamination; coastal water pollution; soil and groundwater contamination; contamination of fruits, vegetables, and seafood; ambient noise; stratospheric ozone depletion; electromagnetic fields from power lines; health impacts from climate change; and exposure to hazardous substances in industrial, construction, and agricultural work environments. Results from workshops involving 73 stakeholders who met in five separate groups to rank these risks individually and collaboratively indicated strong consensus that outdoor and indoor air pollution are the highest priorities in the UAE. Each of the five groups rated these as being among the highest risks. All groups rated soil and groundwater contamination as being among the lowest risks. In surveys administered after the ranking exercises, participants indicated that the results of the process represented their concerns and approved of using the ranking results to inform policy decisions. The results ultimately shaped a strategic plan that is now being implemented.

Using probabilistic terrorism risk modeling for regulatory benefit-cost analysis: application to the Western hemisphere travel initiative in the land environment.

This article presents a framework for using probabilistic terrorism risk modeling in regulatory analysis. We demonstrate the framework with an example application involving a regulation under consideration, the Western Hemisphere Travel Initiative for the Land Environment, (WHTI-L). First, we estimate annualized loss from terrorist attacks with the Risk Management Solutions (RMS) Probabilistic Terrorism Model. We then estimate the critical risk reduction, which is the risk-reducing effectiveness of WHTI-L needed for its benefit, in terms of reduced terrorism loss in the United States, to exceed its cost. Our analysis indicates that the critical risk reduction depends strongly not only on uncertainties in the terrorism risk level, but also on uncertainty in the cost of regulation and how casualties are monetized. For a terrorism risk level based on the RMS standard risk estimate, the baseline regulatory cost estimate for WHTI-L, and a range of casualty cost estimates based on the willingness-to-pay approach, our estimate for the expected annualized loss from terrorism ranges from $2.7 billion to $5.2 billion. For this range in annualized loss, the critical risk reduction for WHTI-L ranges from 7% to 13%. Basing results on a lower risk level that results in halving the annualized terrorism loss would double the critical risk reduction (14-26%), and basing the results on a higher risk level that results in a doubling of the annualized terrorism loss would cut the critical risk reduction in half (3.5-6.6%). Ideally, decisions about terrorism security regulations and policies would be informed by true benefit-cost analyses in which the estimated benefits are compared to costs. Such analyses for terrorism security efforts face substantial impediments stemming from the great uncertainty in the terrorist threat and the very low recurrence interval for large attacks. Several approaches can be used to estimate how a terrorism security program or regulation reduces the distribution of risks it is intended to manage. But, continued research to develop additional tools and data is necessary to support application of these approaches. These include refinement of models and simulations, engagement of subject matter experts, implementation of program evaluation, and estimating the costs of casualties from terrorism events.

The roles of group membership, beliefs, and norms in ecological risk perception.

Variability in ecological risk perceptions was investigated by surveying members of four stakeholder groups commonly involved in environmental policy debates. Fifty-six individuals from government, industry, environmental, and general-public groups completed a risk-perception survey in which they evaluated 34 environmental hazards on 17 attributes and also evaluated the riskiness and acceptability of each hazard. In addition, participants reported their environmental beliefs and norms using Dunlap et al.'s revised New Ecological Paradigm Scale and modified versions of Schwartz's Awareness of Consequences and Personal Norms Scales. Group membership was predictive of participants' scores on the belief and norm scales. Factor analysis of attribute ratings (averaged across participants) revealed the anticipated three oblique factors: ecological impacts, scientific understanding, and aesthetic impacts. Factor patterns were very similar for the four stakeholder groups. Factors from the aggregate analysis were predictive of individuals' riskiness judgments, but these relationships were moderated by participants' group membership, beliefs, and norms. Compared to members of other groups, members of the general public placed less emphasis on ecological impacts and more emphasis on the other two factors when judging the ecological riskiness of hazards. To our knowledge, these results represent the first formal tests of interactions between hazard characteristics and participant characteristics in determining riskiness judgments, and illustrate how traditional psychometric analyses can be successfully coupled with individual-difference measures to improve the understanding of risk perception.

Guiding resource allocations based on terrorism risk.

Establishing tolerable levels of risk is one of the most contentious and important risk management decisions. With every regulatory or funding decision for a risk management program, society decides whether or not risk is tolerable. The Urban Area Security Initiative (UASI) is a Department of Homeland Security (DHS) grant program designed to enhance security and overall preparedness to prevent, respond to, and recover from acts of terrorism by providing financial assistance for planning, equipment, training, and exercise needs of large urban areas. After briefly reviewing definitions of terrorism risk and rationales for risk-based resource allocation, this article compares estimates of terrorism risk in urban areas that received UASI funding in 2004 to other federal risk management decisions. This comparison suggests that UASI allocations are generally consistent with other federal risk management decisions. However, terrorism risk in several cities that received funding is below levels that are often tolerated in other risk management contexts. There are several reasons why the conclusions about terrorism risk being de minimis in specific cities should be challenged. Some of these surround the means used to estimate terrorism risk for this study. Others involve the comparison that is made to other risk management decisions. However, many of the observations reported are valid even if reported terrorism risk estimates are several orders of magnitude too low. Discussion of resource allocation should be extended to address risk tolerance and include explicit comparisons, like those presented here, to other risk management decisions.

Aggregate, disaggregate, and hybrid analyses of ecological risk perceptions.

Laypeople's perceptions of health and safety risks have been widely studied, but only a few studies have addressed perceptions of ecological hazards. We assembled a list of 39 attributes of ecological hazards from the literatures on comparative risk assessment, ecological health, environmental conservation and management, environmental psychology, and risk perception. In Study 1, 125 laypeople evaluated 83 hazards on subsets of this attribute set. Factor analysis of attribute ratings (averaged over participants) revealed six oblique factors: ecological impacts, human impacts, human benefits, aesthetic impacts, scientific understanding, and controllability. These factors predicted mean judgments of overall riskiness, ecological riskiness, acceptability, and regulatory strictness. In Study 2, 30 laypeople each evaluated 34 hazards on 17 attributes and 3 dependent variables. Aggregate-level factor analysis of these data replicated the appropriate portion of the factor solution and yielded similar regression results. Parallel analyses at the individual-participant level yielded factors that explained less variance in judgments of overall riskiness, ecological riskiness, and acceptability. However, the decrease in explanatory power was much less than is often reported for disaggregate-level analyses of psychometric data. This discrepancy illustrates the importance of distinguishing between the level of analysis (aggregate versus disaggregate) and the focus of analysis (distinctions among hazards versus distinctions among participants). In a hybrid analysis, aggregate-level factor scores predicted individual participants' riskiness judgments reasonably well. Psychometric studies such as these provide a sound empirical basis for selecting attributes of ecological hazards for use in comparative risk assessment.

Ecological risk ranking: development and evaluation of a method for improving public participation in environmental decision making.

This article reports an extension of the Carnegie Mellon risk-ranking method to incorporate ecological risks and their attributes. On the basis of earlier risk-perception studies, we identified a set of 20 relevant attributes for describing health, safety, and environmental hazards in standardized risk summary sheets. In a series of three ranking sessions, 23 laypeople ranked 10 such hazards in a fictional Midwestern U.S. county using both holistic and multiattribute ranking procedures. Results were consistent with those from previous studies involving only health and safety hazards, providing additional evidence for the validity of the method and the replicability of the resulting rankings. Holistic and multiattribute risk rankings were reasonably consistent both for individuals and for groups. Participants reported that they were satisfied with the procedures and results, and indicated their support for using the method to advise real-world risk-management decisions. Agreement among participants increased over the course of the exercise, perhaps because the materials and deliberations helped participants to correct their misconceptions and clarify their values. Overall, health and safety attributes were judged more important than environmental attributes. However, the overlap between the importance rankings of these two sets of attributes suggests that some information about environmental impacts is important to participants' judgments in comparative risk-assessment tasks.

Potential exposures and risks from beryllium-containing products.

Beryllium is the strongest of the lightweight metals. Used primarily in military applications prior to the end of the Cold War, beryllium is finding new applications in many commercial products, including computers, telecommunication equipment, and consumer and automotive electronics. The use of beryllium in nondefense consumer applications is of concern because beryllium is toxic. Inhalation of beryllium dust or vapor causes a chronic lung disease in some individuals at concentrations as low as 0.01 microg/m3 in air. As beryllium enters wider commerce, it is prudent to ask what risks this might present to the general public and to workers downstream of the beryllium materials industry. We address this question by evaluating the potential for beryllium exposure from the manufacturing, use, recycle, and disposal of beryllium-containing products. Combining a market study with a qualitative exposure analysis, we determine which beryllium applications and life cycle phases have the largest exposure potential. Our analysis suggests that use and maintenance of the most common types of beryllium-containing products do not result in any obvious exposures of concern, and that maintenance activities result in greater exposures than product use. Product disposal has potential to present significant individual risks, but uncertainties concerning current and future routes of product disposal make it difficult to be definitive. Overall, additional exposure and dose-response data are needed to evaluate both the health significance of many exposure scenarios, and the adequacy of existing regulations to protect workers and the public. Although public exposures to beryllium and public awareness and concern regarding beryllium risks are currently low, beryllium risks have psychometric qualities that may lead to rapidly heightened public concern.