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Introduction: Needs on Emerging Risk and Management
Introduction: Needs on Emerging Risk and Management Benoit Roig1, Francisco Brocal2 1
University of Nıˆmes, EA7352 CHROME, Nıˆmes, France; 2 Department of Physics, Systems Engineering and Sign Theory, Universidad de Alicante, Alicante, Spain
The intensity of scientific and technological development is changing society and its relationship with the environment (domestic, professional, environmental, etc.). These modifications generate new opportunities, but also new threats for human health, safety, economy, the environment, and the social structure. Therefore, society is increasingly concerned about the risks related to these changes, especially about new or increasing risks called “emerging risks.” This problematic leads to society’s greater awareness concerning these risks that are associated with many agents and factors derived from their relation to the environment and whose effects may affect the welfare (physical or psychosocial) of the population today and for generations to come. For several years now, emerging risks have been a subject of high interest, generating studies, and have been a source of debate in the scientific community, in the general population, and by authorities (health, labor, environmental, etc.). The very concept of emerging risk is also a subject of research and debate. Various definitions exist depending on the nature of the risk (Table 1) or the field of study (systemic, technological, occupational, etc.).
Table 1 Example of Emerging risks Emerging Risk Nature Physical Biological Chemical Psychosocial Multiple
Example Electromagnetic fields (information and communication technologies), energy storage (hydrogen), cloud technology, nanotechnology, etc. New applications in medical bioengineering, prions, exported microorganisms (chikungunya, dengue), new pathogens, etc. Endocrine disruptors, pharmaceutical products, disinfectant and disinfection by-products, household products, odors, etc. Job insecurity related to unstable labor markets and precarious contracts, work intensification and high demands at work, work-life balance, etc. Cocktail effect (chemical-chemical, chemical-physical, etc.), medical devices, allergies, climate change, reuse, etc.
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xviii
INTRODUCTION
These definitions are interrelated but do not completely overlap. However, they all take into account the new and changing nature of the emerging risk. These various definitions recognize that: • •
•
the risk did not exist before: e.g., new technologies (Internet of Things, artificial intelligence, etc.) new materials (nanomaterials, composite materials, etc.), or a known risk occurs in a new area: e.g., vector-borne diseases (malaria, dengue, etc.) exported from North Africa to Mediterranean countries (south of France), implementation of an industrial activity in a new area, or a “problem” already long recognized is now considered as risk due to the evolution of the public’s perception, or to an increase of the scientific knowledge, e.g., pharmaceutical and personal care products in the environment and their impact on wildlife and human health.
Unlike conventional and recognized risks (major, occupational, natural, etc.), the new and changing nature of the emerging risk implies a low (or nonexistent) scientific knowledge, high uncertainties in their (mode of) assessment, a high characterization difficulty in the scientific field, and a varying level of acceptability by the competent authorities and the populations exposed. New technologies, nanoparticles, emerging micropollutants (pharmaceuticals products, endocrine disruptors, etc.), climate change, nuclear waste, etc., are examples of emerging issues of which the limits of our knowledge coupled with the methodological difficulties of assessment do not allow to legislate their use or to state the level of risk to the populations. For several of these emerging risks, the scientific debate is only starting. No consensus allows us, firstly, to suggest a regulation, and secondly, to give an objective overview to the population. What is problematic becomes increasingly complex due to a double pressure: the population, who wants to be clearly informed of the legislation and helped in its decision-making; and the media, who want to produce sensational information by using terms taken out of context, not representative of reality and often contradictory. Therefore, the traditional and disciplinary approaches to study risk (experimental, engineering and technological sciences, management sciences, human and social sciences, etc.) fail when emerging issues need to be investigated. Indeed, although such strategy may be appropriate when problems have simple causes and clearly defined solutions, it is not adapted when the complexity of particular problems is assessed with limited knowledge and relative certainties. In that case, it is important to break the boundaries between the understanding of the risk (risk sources, causes, consequences, etc.), and the social, political, and economic system that determines the ways to reduce or at least limit the impact. Indeed, for the population, an incorrect risk assessment or interpretation can lead to denial, unrealistic optimism, illusions of invulnerability and control, delegation of responsibilities, or to a phenomenon of social amplification of risk. In all of these cases, the behaviors adopted by individuals or communities will be inadequate and will increase in vulnerability. Such lack of clarity and precision about these risks (and the consequences expected) may also be the source of growing disputes (litigation, conflict, jurisprudence, etc.), and of unreasonable behaviors that are sometimes irrational or even dangerous, including in decision-making. Emerging risks cannot be characterized without crossed approaches (human and social sciences and technological sciences) analyzing and managing the phenomenon linked to their occurrence and their consideration on the scientific level or in the public, the media, and in political decision-making. They need to be studied by combining the different approaches in order to provide more enlightened decision-making.
INTRODUCTION
xix
This book aims to present examples of transdisciplinary approaches used to characterize, analyze, and manage a specific risky situation, considered as emerging. In the framework of environmental health, risk assessment has greatly evolved in the last few decades. One of these new concepts is the concept of exposome, born in 2005. The idea behind this concept is that factors contributing to human diseases are not only genetic and environmental. Other parameters are important as well, including lifestyle, economic or social factors existing from the prenatal period. The concept has rapidly grown in popularity, even if it still raises many interpretations and needs to be more detailed. In a preliminary chapter, Sarigiannis et al. present the concept, some international initiatives and projects, and several applications. In the following chapters, examples of three categories of emergence are provided. The first chapter presents articles dealing with new risks. In chapter 1, Sarigiannis et al. analyze the current data of a multiple exposure to health risks in the specific context of built environments. Built environments can be contaminated via various sources: traffic proximity (PM, NO2), combustion sources such as biomass for space heating (PM, PAHs), smoke (PM, PAHs, VOCs, carbonyls), building materials (VOCs), furnishings (carbonyls and phthalates), and household products (phthalates, flame retardants, PCBs, and pesticides). The cumulative effect of these substances is not studied enough, whereas people are constantly exposed to them. In chapter 2, Brocal et al. discuss how the constant progress of new technologies and new manufacturing processes generates the emergence of new risks, both systemic and occupational nature. In a first step, the main emerging risks are exposed. Amongst the fields of application of these risks, some of the most important cross-cutting manufacturing technologies have been selected. In a second step, the chapter presents one of the main frameworks of risks governance and illustrates it through the management and characterization of emerging risks. Finally, in the third chapter of this first part, Matt Hull addresses the problematics of nanotechnology and public health. Nanotechnologies have rapidly evolved in many fields (nanomaterials, medicines, diagnostic tools, etc.). The benefits of these technological advances are undisputable but the risks of their applications are real. The complexity of nanotechnology is a dual matter: on the one hand, it has opened up new perspectives regarding human welfare, such as progress in the energy sector, in electronic products, in the field of medicine; and on the other hand, unexpected effects of nanoproducts on the environment (emissions to air, water, and soil) and public health (interactions with body tissues, cells, etc.) are described. The chapter provides an overview on the many ways that nanotechnology may impact public health both positively and negatively, showing that more than ever, the benefit/risk ratio needs to be very objectively and conscientiously studied. The second series of emerging risk described in this book concerns risks already identified (sometimes well characterized) but occurring in new areas. In particular, this is the case with vectorborne diseases. Indeed, vector-borne diseases have been present at man’s side for a long time. They are mostly widespread in tropical and subtropical regions, in particular, when there is no access to safe drinking water and health systems. But climate change or global travel can impact the transmission process, in particular in countries where those diseases were previously unknown. The risks that arise during the emergence of vector-borne diseases in new areas can concern human, animal, and environmental health. In chapter 4, Savic et al. discuss the progress in the diagnostic research and examples of vectors and pathogens distributed in new areas. As vector-borne diseases are a matter of public health, it is important to understand, analyze, assess, and manage the risk associated with them.
xx
INTRODUCTION
The second article of this part deals with radioactivity as an emerging risk. In an unconventional way, crossing psychological, chemical, economic, and legal points of view, Jaeger et al. provides in chapter 5 a comprehensive overview on the management of radioactive remains (essentially, the management of low radioactive emissions). Whereas a nuclear plant accident is a high concern for the world’s population, much less attention is paid today to permanent exposure to low doses of radioactive elements. However, this risk exists in both the medical and industrial fields and needs to be considered with care. In the last chapter of this part (chapter 6), Patrick Rateau et al. present the biological invasions related to the spread of some species outside their natural habitats due to climate change. These invasions concern plants as well as animals. This issue is characterized by a scientific uncertainty that leads to various conclusions and to differentiated management choices. In this context of scientific uncertainty, perceptions are highly dissimilar. Therefore, individuals concerned by the problem will not react depending on the reality described by biologists, but rather according to their perceptions of the spread and on the representation that they have of the species. The objective of this chapter is to illustrate this process from two examples: the spread of jellyfish in the Mediterranean area, and the colonization of knotweeds (Fallopia) in the Rhoˆne department and the Gard department of France. Finally, the last part of the book returns to the subject of recognized situations recently considered as risks due to media or political interests or by new scientific knowledge. Today, one of the main growing threats to the environment and human health is antimicrobial resistance. This problem is a major concern, with the environment now recognized for its role in the dissemination of resistant bacteria or as a source of new types of resistance to pathogens. This concern is even more serious since therapeutic alternatives are increasingly absent (research on new generations of antibiotics is very low). In two complementary chapters (7 and 10), Sanderson et al. and Bengtsson-Palme discuss the current research related to antimicrobial resistance in the environment (AMR) and the issues related to risk assessment and surveillance, and the incorporation of AMR, which is problematic, into legal frameworks and regulations, public health action plans, and global partnerships that aim to fight against AMR. Another subject of recent interest is the presence of pharmaceutical products in the environment. Data have shown the likelihood of finding such substances in drinking water and food products (vegetables or seafood products, for instance). Despite the lack of certainties about the risks for human health, there is an effective motivation to find solutions to moderate the emissions of these substances into the environment. In parallel to technical and end-of-pipe options (water treatment), upstream options can be suggested by involving the different actors of the life cycle of pharmaceutical products. In chapter 8, Goetz et al. focus on consumers’ and health experts’ perceptions of risks caused by pharmaceutical residues in the marine environment. The aim of this study is to make doctors and pharmacists aware of this issue and to qualify them for the measures to be taken in their daily professional life. Chapter 9 focuses on pesticides. Although pesticides are no longer emerging subjects, new questions are raised due to the use of contaminated water for plant production (irrigation). This matter is one of the bases for the conversion to organic farming, although the toxicity of pesticides on nontarget organisms is becoming increasingly low. In this chapter, Valette et al. try to understand what motivates the conversion, or the nonconversion, to more respectful agricultural practices.
INTRODUCTION
xxi
The development of the three parts of this book just described follows the common thread connected to the different definitions of emerging risk due to its new and changing nature. In this way, the first part deals mainly with the new nature of the emerging risk and the second and third parts with the changing nature of the emerging risk, considering new areas and the increase of scientific knowledge and/or changes in the population’s perceptions. With this common thread, the complex connections that occur in a world where globalization and technological development increase exponentially in an interrelated way are shown. This scenario is strongly linked to the life cycle of new products, processes, and activities, which generate emerging risks linked to knowledge of great relevance in the field of public health. Finally, it is important to emphasize that two of the main characteristics of emerging risk are low scientific knowledge and high scientific uncertainty. In this way, this book represents a step forward to improve knowledge and reduce the uncertainty around the management of emerging public health issues and risks. In the future, this step will have to be accompanied by new multidisciplinary approaches and advances that will continue to promote populations’ safety, security, health, and welfare.
University of Nıˆmes, EA7352 CHROME, Nıˆmes, France; 2 Department of Physics, Systems Engineering and Sign Theory, Universidad de Alicante, Alicante, Spain
The intensity of scientific and technological development is changing society and its relationship with the environment (domestic, professional, environmental, etc.). These modifications generate new opportunities, but also new threats for human health, safety, economy, the environment, and the social structure. Therefore, society is increasingly concerned about the risks related to these changes, especially about new or increasing risks called “emerging risks.” This problematic leads to society’s greater awareness concerning these risks that are associated with many agents and factors derived from their relation to the environment and whose effects may affect the welfare (physical or psychosocial) of the population today and for generations to come. For several years now, emerging risks have been a subject of high interest, generating studies, and have been a source of debate in the scientific community, in the general population, and by authorities (health, labor, environmental, etc.). The very concept of emerging risk is also a subject of research and debate. Various definitions exist depending on the nature of the risk (Table 1) or the field of study (systemic, technological, occupational, etc.).
Table 1 Example of Emerging risks Emerging Risk Nature Physical Biological Chemical Psychosocial Multiple
Example Electromagnetic fields (information and communication technologies), energy storage (hydrogen), cloud technology, nanotechnology, etc. New applications in medical bioengineering, prions, exported microorganisms (chikungunya, dengue), new pathogens, etc. Endocrine disruptors, pharmaceutical products, disinfectant and disinfection by-products, household products, odors, etc. Job insecurity related to unstable labor markets and precarious contracts, work intensification and high demands at work, work-life balance, etc. Cocktail effect (chemical-chemical, chemical-physical, etc.), medical devices, allergies, climate change, reuse, etc.
xvii
xviii
INTRODUCTION
These definitions are interrelated but do not completely overlap. However, they all take into account the new and changing nature of the emerging risk. These various definitions recognize that: • •
•
the risk did not exist before: e.g., new technologies (Internet of Things, artificial intelligence, etc.) new materials (nanomaterials, composite materials, etc.), or a known risk occurs in a new area: e.g., vector-borne diseases (malaria, dengue, etc.) exported from North Africa to Mediterranean countries (south of France), implementation of an industrial activity in a new area, or a “problem” already long recognized is now considered as risk due to the evolution of the public’s perception, or to an increase of the scientific knowledge, e.g., pharmaceutical and personal care products in the environment and their impact on wildlife and human health.
Unlike conventional and recognized risks (major, occupational, natural, etc.), the new and changing nature of the emerging risk implies a low (or nonexistent) scientific knowledge, high uncertainties in their (mode of) assessment, a high characterization difficulty in the scientific field, and a varying level of acceptability by the competent authorities and the populations exposed. New technologies, nanoparticles, emerging micropollutants (pharmaceuticals products, endocrine disruptors, etc.), climate change, nuclear waste, etc., are examples of emerging issues of which the limits of our knowledge coupled with the methodological difficulties of assessment do not allow to legislate their use or to state the level of risk to the populations. For several of these emerging risks, the scientific debate is only starting. No consensus allows us, firstly, to suggest a regulation, and secondly, to give an objective overview to the population. What is problematic becomes increasingly complex due to a double pressure: the population, who wants to be clearly informed of the legislation and helped in its decision-making; and the media, who want to produce sensational information by using terms taken out of context, not representative of reality and often contradictory. Therefore, the traditional and disciplinary approaches to study risk (experimental, engineering and technological sciences, management sciences, human and social sciences, etc.) fail when emerging issues need to be investigated. Indeed, although such strategy may be appropriate when problems have simple causes and clearly defined solutions, it is not adapted when the complexity of particular problems is assessed with limited knowledge and relative certainties. In that case, it is important to break the boundaries between the understanding of the risk (risk sources, causes, consequences, etc.), and the social, political, and economic system that determines the ways to reduce or at least limit the impact. Indeed, for the population, an incorrect risk assessment or interpretation can lead to denial, unrealistic optimism, illusions of invulnerability and control, delegation of responsibilities, or to a phenomenon of social amplification of risk. In all of these cases, the behaviors adopted by individuals or communities will be inadequate and will increase in vulnerability. Such lack of clarity and precision about these risks (and the consequences expected) may also be the source of growing disputes (litigation, conflict, jurisprudence, etc.), and of unreasonable behaviors that are sometimes irrational or even dangerous, including in decision-making. Emerging risks cannot be characterized without crossed approaches (human and social sciences and technological sciences) analyzing and managing the phenomenon linked to their occurrence and their consideration on the scientific level or in the public, the media, and in political decision-making. They need to be studied by combining the different approaches in order to provide more enlightened decision-making.
INTRODUCTION
xix
This book aims to present examples of transdisciplinary approaches used to characterize, analyze, and manage a specific risky situation, considered as emerging. In the framework of environmental health, risk assessment has greatly evolved in the last few decades. One of these new concepts is the concept of exposome, born in 2005. The idea behind this concept is that factors contributing to human diseases are not only genetic and environmental. Other parameters are important as well, including lifestyle, economic or social factors existing from the prenatal period. The concept has rapidly grown in popularity, even if it still raises many interpretations and needs to be more detailed. In a preliminary chapter, Sarigiannis et al. present the concept, some international initiatives and projects, and several applications. In the following chapters, examples of three categories of emergence are provided. The first chapter presents articles dealing with new risks. In chapter 1, Sarigiannis et al. analyze the current data of a multiple exposure to health risks in the specific context of built environments. Built environments can be contaminated via various sources: traffic proximity (PM, NO2), combustion sources such as biomass for space heating (PM, PAHs), smoke (PM, PAHs, VOCs, carbonyls), building materials (VOCs), furnishings (carbonyls and phthalates), and household products (phthalates, flame retardants, PCBs, and pesticides). The cumulative effect of these substances is not studied enough, whereas people are constantly exposed to them. In chapter 2, Brocal et al. discuss how the constant progress of new technologies and new manufacturing processes generates the emergence of new risks, both systemic and occupational nature. In a first step, the main emerging risks are exposed. Amongst the fields of application of these risks, some of the most important cross-cutting manufacturing technologies have been selected. In a second step, the chapter presents one of the main frameworks of risks governance and illustrates it through the management and characterization of emerging risks. Finally, in the third chapter of this first part, Matt Hull addresses the problematics of nanotechnology and public health. Nanotechnologies have rapidly evolved in many fields (nanomaterials, medicines, diagnostic tools, etc.). The benefits of these technological advances are undisputable but the risks of their applications are real. The complexity of nanotechnology is a dual matter: on the one hand, it has opened up new perspectives regarding human welfare, such as progress in the energy sector, in electronic products, in the field of medicine; and on the other hand, unexpected effects of nanoproducts on the environment (emissions to air, water, and soil) and public health (interactions with body tissues, cells, etc.) are described. The chapter provides an overview on the many ways that nanotechnology may impact public health both positively and negatively, showing that more than ever, the benefit/risk ratio needs to be very objectively and conscientiously studied. The second series of emerging risk described in this book concerns risks already identified (sometimes well characterized) but occurring in new areas. In particular, this is the case with vectorborne diseases. Indeed, vector-borne diseases have been present at man’s side for a long time. They are mostly widespread in tropical and subtropical regions, in particular, when there is no access to safe drinking water and health systems. But climate change or global travel can impact the transmission process, in particular in countries where those diseases were previously unknown. The risks that arise during the emergence of vector-borne diseases in new areas can concern human, animal, and environmental health. In chapter 4, Savic et al. discuss the progress in the diagnostic research and examples of vectors and pathogens distributed in new areas. As vector-borne diseases are a matter of public health, it is important to understand, analyze, assess, and manage the risk associated with them.
xx
INTRODUCTION
The second article of this part deals with radioactivity as an emerging risk. In an unconventional way, crossing psychological, chemical, economic, and legal points of view, Jaeger et al. provides in chapter 5 a comprehensive overview on the management of radioactive remains (essentially, the management of low radioactive emissions). Whereas a nuclear plant accident is a high concern for the world’s population, much less attention is paid today to permanent exposure to low doses of radioactive elements. However, this risk exists in both the medical and industrial fields and needs to be considered with care. In the last chapter of this part (chapter 6), Patrick Rateau et al. present the biological invasions related to the spread of some species outside their natural habitats due to climate change. These invasions concern plants as well as animals. This issue is characterized by a scientific uncertainty that leads to various conclusions and to differentiated management choices. In this context of scientific uncertainty, perceptions are highly dissimilar. Therefore, individuals concerned by the problem will not react depending on the reality described by biologists, but rather according to their perceptions of the spread and on the representation that they have of the species. The objective of this chapter is to illustrate this process from two examples: the spread of jellyfish in the Mediterranean area, and the colonization of knotweeds (Fallopia) in the Rhoˆne department and the Gard department of France. Finally, the last part of the book returns to the subject of recognized situations recently considered as risks due to media or political interests or by new scientific knowledge. Today, one of the main growing threats to the environment and human health is antimicrobial resistance. This problem is a major concern, with the environment now recognized for its role in the dissemination of resistant bacteria or as a source of new types of resistance to pathogens. This concern is even more serious since therapeutic alternatives are increasingly absent (research on new generations of antibiotics is very low). In two complementary chapters (7 and 10), Sanderson et al. and Bengtsson-Palme discuss the current research related to antimicrobial resistance in the environment (AMR) and the issues related to risk assessment and surveillance, and the incorporation of AMR, which is problematic, into legal frameworks and regulations, public health action plans, and global partnerships that aim to fight against AMR. Another subject of recent interest is the presence of pharmaceutical products in the environment. Data have shown the likelihood of finding such substances in drinking water and food products (vegetables or seafood products, for instance). Despite the lack of certainties about the risks for human health, there is an effective motivation to find solutions to moderate the emissions of these substances into the environment. In parallel to technical and end-of-pipe options (water treatment), upstream options can be suggested by involving the different actors of the life cycle of pharmaceutical products. In chapter 8, Goetz et al. focus on consumers’ and health experts’ perceptions of risks caused by pharmaceutical residues in the marine environment. The aim of this study is to make doctors and pharmacists aware of this issue and to qualify them for the measures to be taken in their daily professional life. Chapter 9 focuses on pesticides. Although pesticides are no longer emerging subjects, new questions are raised due to the use of contaminated water for plant production (irrigation). This matter is one of the bases for the conversion to organic farming, although the toxicity of pesticides on nontarget organisms is becoming increasingly low. In this chapter, Valette et al. try to understand what motivates the conversion, or the nonconversion, to more respectful agricultural practices.
INTRODUCTION
xxi
The development of the three parts of this book just described follows the common thread connected to the different definitions of emerging risk due to its new and changing nature. In this way, the first part deals mainly with the new nature of the emerging risk and the second and third parts with the changing nature of the emerging risk, considering new areas and the increase of scientific knowledge and/or changes in the population’s perceptions. With this common thread, the complex connections that occur in a world where globalization and technological development increase exponentially in an interrelated way are shown. This scenario is strongly linked to the life cycle of new products, processes, and activities, which generate emerging risks linked to knowledge of great relevance in the field of public health. Finally, it is important to emphasize that two of the main characteristics of emerging risk are low scientific knowledge and high scientific uncertainty. In this way, this book represents a step forward to improve knowledge and reduce the uncertainty around the management of emerging public health issues and risks. In the future, this step will have to be accompanied by new multidisciplinary approaches and advances that will continue to promote populations’ safety, security, health, and welfare.