2. Institute for Research in Extramural Medicine vrije UniversiteitAmsterdam Risk perception and risk communication in occupational health Tjabe Smid KLM health safety & environment EMGO-Institute Free University Amsterdam

3. Personal 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 ‘political’ arena),In advising on environmental noise and safety (in a ‘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 among workers involved in salvage and cleanup after an airplane crash.As project leader in a study into health complaints among workers involved in salvage and cleanup after an airplane crash.

4. Program I. Why is risk communication increasingly important? I. Why is risk communication increasingly important? II. Risk perception II. Risk perception III. Risk communication III. Risk communication IV. Lessons (to be?) learned IV. Lessons (to be?) learned

5. I. Why risk communication is important I. Why risk communication is important Increasing job demands and productivityIncreasing job demands and productivity -> potentially conflicting with safety goals -> potentially conflicting with safety goals Increasing personal responsibilities through empowermentIncreasing personal responsibilities through empowerment Perceived risk is more importantPerceived risk is more important Less chemical and physical hazardsLess chemical and physical hazards -> stress-related influences are more important -> stress-related influences are more important

6. Example: Post …. syndromes After major disasters, war, etceteraAfter major disasters, war, etcetera With marginal chemical/physical riskWith marginal chemical/physical risk Many health complaintsMany health complaints Functional somatic syndromes:Functional somatic syndromes: –General, diffuse, common symptoms –Explicit self-diagnoses Comparable to SBS, multiple chemical sensitivityComparable to SBS, multiple chemical sensitivity

7. Functional somatic syndromes Symptoms somatic and psychologicalSymptoms somatic and psychological Fatigue, weakness, headache, sleep disturbances, musculoskeletal, gastro-intestinal, skin complaints, respiratory problems, fear and anxiety, depressionFatigue, weakness, headache, sleep disturbances, musculoskeletal, gastro-intestinal, skin complaints, respiratory problems, 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 effectsOr stress -> central nervous system effect -> immunologic effects Communication is crucial!Communication is crucial!

8. Program I. Why is risk communication increasingly important? I. Why is risk communication increasingly important? II. Risk perception II. Risk perception III. Risk communication III. Risk communication IV. Lessons (to be?) learned IV. Lessons (to be?) learned

9. II. Risk perception Experts and the public (workers) differ in their perception of riskExperts and the public (workers) differ in their perception of risk Experts try to evaluate risk using:Experts try to evaluate risk using: –Numbers and statistics –Relative ranking The public (workers) evaluate and ranks risk intuitivelyThe public (workers) evaluate and ranks risk intuitively But there are patterns in risk perceptionBut there are patterns in risk perception

10. Intuition overestimates risk when: 1.The effect is larger (especially catastrophic) 2.Exposure is not voluntarily 3.Risk/effect is lesser known 4.Sensory perception is difficult 5.There is less personal control 6.Effects are long-term 7.Risk is man-made 8.Previous incidents have happened, (with victim identity) 9.Experts are not consistent 10.There is less confidence in people in control 11.There is more media attention

11. 1. Larger effects The risk of large scale accidents and catastrophes is overestimated (plane vs. car accidents)The risk of large scale accidents and catastrophes is overestimated (plane vs. car accidents) And large scale accidents appear to have more psychological impactAnd large scale accidents appear to have more psychological impact

12. 2. Voluntary risks Voluntary risks are underestimatedVoluntary risks are underestimated This factor may explain (among others) why workers don’t wear PPD when it is not compulsoryThis factor may explain (among others) why workers don’t wear PPD when it is not compulsory

13. 3. Risk is less known Unfamiliar risk is overestimatedUnfamiliar risk is overestimated I.e. chemical risk is considered more severe than example falling, or back injuriesI.e. chemical risk is considered more severe than example falling, or back injuries

14. 4. 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

15. 5. Less personal control Relates to 2. (voluntary risk)Relates to 2. (voluntary risk) Perceived control leads to a less severe risk perceptionPerceived control leads to a less severe risk perception 80 % of the Dutch consider their driving above average80 % of the Dutch consider their driving above average

16. 6. Long term effects Workers are more afraid of long term health effects, than of short term effectsWorkers are more afraid of long term health effects, than of short term effects

17. 7. Man made risk Man made risks (chemical, nuclear) are perceived more severe than for example lightning, storm, or floodingMan made risks (chemical, nuclear) are perceived more severe than for example lightning, storm, or flooding

18. 8. 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

19. 9. Experts are not consistent Or not perceived consistentOr not perceived consistent Internet information is also considered expert opinionInternet information is also considered expert opinion

20. 10 Less confidence in people responsible for control and information Especially when risk is not familiar, not known, not sensory perceived, people have to rely on others for their informationEspecially when risk is not familiar, not known, not sensory perceived, people have to rely on others for their information

21. 11. Media attention Last but not least!Last but not least!

22. Examples 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

23. Radiation incident 1.The effect is larger (especially catastrophic) - 2.Exposure is not voluntarily ++ 3.Risk/effect is lesser known + 4.Sensory perception is difficult +++ 5.There is less personal control ++ 6.Effects are long-term +++ 7.Risk is man-made +++ 8.Previous incidents have happened, (with victim identity) +/- 9.Experts are not consistent + (internet) 10.There is less confidence in people in control ++ (2 months lag) 11.There is more media attention ++++

24. Falls in maintenance 1.The effect is larger (especially catastrophic) + / - - 2.Exposure is not voluntarily - / + 3.Risk/effect is lesser known - - - 4.Sensory perception is difficult - 5.There is less personal control - - - 6.Effects are long-term - - - 7.Risk is man-made -/+ 8.Previous incidents have happened, (with victim identity) + 9.Experts are not consistent - - - 10.There is less confidence in people in control - - 11.There is more media attention - - -

25. Program I. Why is risk communication increasingly important? I. Why is risk communication increasingly important? II. Risk perception II. Risk perception III. Risk communication III. Risk communication IV. Lessons (to be?) learned IV. Lessons (to be?) learned

26. III. Risk communication There is no standard risk communication !

27. Risk communication 1.Know your target group(s) 2.Know your goal 3.Know the expectations 4.Be trustworthy 5.The message should be unequivocal 6.Be timely 7.Be open and transparent 8.Be consistent 9.Keep the initiative

28. 1. Know your target group I.e. –Workers involved Victims Others –Uninvolved workers –Their representatives –Their management –Third parties (among others media)

29. 2. 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 behaviour –Prevention of stress: reassurance –Compliance –Prevention of reliability

30. Know your goal (2) KnowledgeKnowledge SkillsSkills AttitudesAttitudes BehaviourBehaviour

31. 3. Know the expectations What, how, when does the target group needs informationWhat, how, when does the target group needs information Consider perception, cultureConsider perception, culture I.e. symptoms are somatic in Functional somatic syndromesI.e. symptoms are somatic in Functional somatic syndromes Know your role as perceived by the target groupKnow your role as perceived by the target group

32. 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 –Position –Age –Gender

33. 5. The message should be unequivocal 5. The message should be unequivocal Not too many detailsNot too many details Emphasize what is knownEmphasize what is known Coordinate different speakersCoordinate different speakers Know that your perception of competence may differ from that of your target group (‘The American professor’)Know that your perception of competence may differ from that of your target group (‘The American professor’)

34. 6/7/8. Be timely, consistent and transparent Total transparency and opennessTotal 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 escapeNever keep something ‘under the hat’ that may escape

35. 9. 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

36. Program I. Why is risk communication increasingly important? I. Why is risk communication increasingly important? II. Risk perception II. Risk perception III. Risk communication III. Risk communication IV. Lessons (to be?) learned IV. Lessons (to be?) learned

37. IV Lessons (to be) learned Risk perception shows a consistent patternRisk perception shows a consistent pattern Recognition of this phenomenon among professionals is marginalRecognition of this phenomenon among professionals is marginal 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 role an contents of the message)Knowing the perspective of the worker is very important (on your 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

38. Thank you. Any questions?