1. RISK COMMUNICATION; MANAGING RISK PERCEPTION WHEN THE EXPERTS AND WORKERS HAVE DIFFERENT OPINIONS Marie Anne V Sanon, Sukriti Singhal, Kristy A Ivicek, Jackelin Tran

2. Risk Communication Very difficult to do both at the same time The risks that kill people are very different from the risks that upset them “Scaring People” Alerting “Comforting People“ Reassuring

3. Hazard vs Outrage People are by and large apathetic to most risks Not because experts have not explained the risk (e.g., smoking) Not because people are “stupid” (e.g., people know that smoking kills)

4. Risk = Hazard + Outrage Risk can be defined as “Hazard + Outrage” or better still f(H,O) – Hazard is Magnitude x Probability – The thing that people actually worry about (but experts ignore) is Outrage In reality, public cares as little about the hazard as experts do about outrage – Public often misperceives the hazard – Experts often misperceive the outrage

5. Outrage Is as real as hazard Is as measureable as hazard Is as manageable as hazard Is as much a part of risk as hazard Is as much a job of communicator as hazard. Decisions about hazard that are a reaction to outrage are usually wrong Recognize outrage but keep it separate from hazard

6. 12 Components of Outrage [1] 1. Is it Voluntary or Coerced?  Risky behavior like smoking is voluntary, but putting a nuclear power plant in my backyard without my knowledge is not! 2.Is it Natural or Industrial?  A tsunami is natural, but an oil spill is not  Invoking the example of a similar natural risk is not the way to decrease the outrage

7. 12 Components of Outrage [2] 3. Is it Familiar or Exotic?  Radiation in my basement is familiar but my house built on industrial waste site without prior disclosure is not  Make the unfamiliar familiar (e.g., superfund site cleanup) 4. Is it Not Memorable or Memorable? - The Alar controversey? - Acknowledge the memorable

8. 12 Components of Outrage [3] 5. Is it Not Dreaded or Dreaded? - 55-gallon drum of hazardous material with and without a label - Legitimize dread 6. Is it Chronic or Catastrophic? - Smell from a manufacturing plant vs a silent gas leak of Bhopal tragedy - Low probability, high magnitude event is likely to generate more outrage

9. 12 Components of Outrage [4] 7. Is it Knowledgeable or Not Knowledgeable? - Uncertainty, expert disagreement, detectability - Make the risk more knowledgeable - Improve detectability 8. Is it Controlled By Me or By Others? - Am I holding the knife or the turkey? - Share control

10. 12 Components of Outrage [5] 9. Is it Fair or Unfair? - The benefit of a refinery may outweigh the risk, but is it fair to install it in an underprivileged neighborhood? - Share the benefits through “negotiation” not “philanthropy” 10. Is it Morally Irrelevant or Morally Relevant? - ”The optimal number of molested children for 2009 is 20”

11. 12 Components of Outrage [6] 11. Can I trust You or Not? - People know a liar when they see one - Trustworthiness is a stand in for hazard - Build trust - Learn to be accountable - Replace trust with Accountability

12. 12 Components of Outrage [7] 12. Is the Process Responsive or Unresponsive? - Openness vs. Secrecy - Apology vs. Stonewalling - Courtesy vs. Discourtesy - Sharing vs. Confronting Values - Compassion vs. Dispassion

13. Hazard vs. Outrage  Hazard = “How much harm it’s likely to do”  Outrage = “How upset it’s likely to make people”  Prevention vs. addressing outcomes  Response to hazard only if risk is high  Mostly focus on outrage

14. 4 Tasks For Risk Communication Source: http://www.psandman.com/index- intro.htm

15. Reduced & Explained Hazard But Public still Not Find Risk Intolerable. So What Now ? Sandman, 1993, p79  Find ways to ask permission  ***Do not compare risk you are imposing on people with natural risks  ***Make the risk more familiar: explain the bad news  ***Acknowledge the ways in which the risk is memorable  ***Legitimate the dread  Take catastrophe more seriously  Increase the know-ability: remember that neon sign on the roof of the incinerator  Share the knife  Share the benefits more fairly  Acknowledge the moral relevance of pollution  Build trust and don’t demand too much trust  ***Respond to people openly, apologetically when you have screwed up, courteously even if they are discourteous with attention to their values and compassion for their concerns

16. Industry& Government vs. Activist vs. Public  Industry and government : risk are small and acceptable  Activist: Risk are unacceptably large and requires action  Public: Angry, suspicious

17. “Outrage reduction is putting your money where your mouth is, betting that if you share the information, share the control and keep the outrage from getting in the way people will make pretty good decisions about risk” (Sandman, 1993, p80)

18. Beliefs That Can Hinder Outrage Reduction  No sign of outrage so no action/change  No need to address the outrage, might alarm the public  Not acknowledging the merits of the opposing arguments  Too late to calm outraged people  Outrage is caused by activists and reporters  Do not accept exaggerated hazards, it is not scientific and it is dishonest  Outrage increases liability  If worked too well outrage reduction might leave the public at risk for “outrage is the best way to force hazard reduction” (p114)

19. Four Stages of Risk Communication  Stonewall Stage  Missionary Stage  Dialogue Stage  Organizational Stage

20. Developmental Stages in Risk Management Fischhoff, 1995, p138  All we have to do is get the numbers right  All we have to do is tell them the numbers  All we have to do is explain what we mean by the numbers  All we have to do is show them that they’ve accepted similar risk in the past  All we have to do is show then that it is a good deal for them  All we have to do is treat them nice  All we have to do is make them partners  All of the above

21. Resources for Risk Communication: EPA http://www.epa.gov/nrmrl/pubs/625r02004/625r02004.pdf http://www.epa.gov/nrmrl/pubs/625r02011/625r02011.pdf

22. References  Fischhoff, B. (1995). Risk perception and communication unplugged: Twenty years of process. Risk Analysis, 15(2), 137-145  Sandman, P. (1993). Responding to community outrage: Strategies for effective risk communication. American Industrial Hygiene Association, Fairfax, Va.  Sandman, P. Risk=Hazard + Outrage. The Peter Sandman Risk Communication Website. Retrieved on 11/ 13/08 from http://www.psandman.com/index-intro.htm http://www.psandman.com/index-intro.htm

23. ARTICLE: ANTHRAX ON CAPITOL HILL North, et al. (2005). Concerns of Capitol Hill staff workers after bioterrorism: focus group discussions of authorities’ response

24. Background Context  Sept. 11 attacks  Anthrax in New York and Florida  Some preparedness training done on Capitol Hill  Oct. 15, 2001: staff member in Tom Daschle’s office opens an envelope with powdery substance

25. Inhalational Anthrax  Significantly higher mortality than cutaneous form  Can spread across long distances when airborne (not spread person-to-person)  Two phases  Prodrome: looks like flu, lasts 4 days  May initially seem to get better  Then rapid clinical deterioration Resp. distress, septic shock, cyanosis, and stridor due to rapidly enlarging pleural effusions Very poor survival

26. What happened on Capitol Hill?  Employee called police immediately, first responders arrived within 5 minutes  Daschle’s and neighboring office detained  Exposed people given prophylactic antibiotics  Nasal swabs used as an epidemiological tool  Swabs and abx later offered to others  Eventual closure of buildings

27. Focus Groups  3 months after the incident  28 House and Senate staff members, recruited by word-of-mouth  From exposed and non-exposed offices  Most discussed issue: communication from authorities!

28. Discussion  How did communication affect these individuals’ experience of the anthrax attacks?  What was done well?  What could have been done better?  Are the criticisms justified or realistic?

29. References  Frazier, A.A. et al. (2006). Inhalational anthrax. Journal of Thoracic Imaging, 21(4).  Hsu, V.P. et al. (2002). Opening a Bacillus anthracis- containing envelope, Capitol Hill, Washington, D.C.: the public health response. Emerging Infectious Diseases, 8(10).  North, et al. (2005). Concerns of Capitol Hill staff workers after bioterrorism: focus group discussions of authorities’ response. Journal of Nervous and Mental Disease, 193(8).