The Illusion of Certainty

1. Front Matter

   Pages i-xx

   PDF

2. The Basics

   1. Front Matter

      Pages 2-2

      PDF

   2. The Illusion of Certainty

      Pages 3-14

   3. Cause and Effect vs. Risk Factors

      Pages 15-29

   4. Reframing the Debate

      Pages 31-36

   5. Assessing Human Health Risks from Environmental Contaminants

      Pages 37-52

   6. The Sources of Uncertainty

      Pages 53-70

3. Case Studies

   1. Front Matter

      Pages 72-72

      PDF

   2. VioxxTM and Heart Attacks

      Pages 73-76

   3. Prostate Cancer Screening

      Pages 77-81

   4. Elevated Cholesterol: A Primary Risk Factor for Heart Disease?

      Pages 83-92

   5. Statins, Cholesterol, and Coronary Heart Disease

      Pages 93-103

   6. Colorectal Cancer Screening

      Pages 105-108

   7. Health Effects of Smoking

      Pages 109-115

   8. Chlorination of Drinking Water and Health Risks

      Pages 117-125

   9. Exposure to Residential Radon and the Risk of Lung Cancer

      Pages 127-132

   10. Ecological Risk Assessment

       Pages 133-139

   11. Asian Oysters in the Chesapeake Bay

       Pages 141-151

   12. Chromium and Sediment Toxicity

       Pages 153-163

4. Perspectives

   1. Front Matter

      Pages 166-166

      PDF

Risk analysis and risk assessment have been with us long enough for the terms to sound familiar to most people. Standard fare for the nuclear power industry and the military for a half a century or more, risk assessment is now a routine aspect of environmental management, public health and individual medical decision making. There have been popular books on risk, and the current poker craze will likely spread risk concepts to an even wider (and younger) audience. Yet, despite all of this extensive and varied experience, we the analysts and practitioners have not done nearly enough to explain to the people who need to know what they need to know – especially the uncertainty inherent in risk estimates. There are many instances in which the failure to communicate risk information accurately or completely has had an important and material impact on decisions and actions. I have been involved in some of these, ranging from local plans for water management to national decisions about nuclear waste. I have seen first hand the effects of poorly done risk asse- ments and bad risk communication, and especially the way in which the uncertainly of risk estimates is handled (or mishandled). The con- quences of doing this wrong are high. It’s high time that we addressed this gap in understanding, and this book is an excellent and important step in doing so.

• Assessment
• Medical Screening
• cancer screening
• human health risk
• organization
• risk assessment
• screening
• toxicity
• uncertainty

From the reviews:

"The aim is principally to assist the public in comprehending and interpreting health benefit and risk information, and provide them with the basic methods that will allow them to make their own judgements. … A significant feature of the book is the introduction of a new way of assisting the reader to conceptualise the absolute risk or benefit to an individual. … It could be used as a reference book by a member of the public … ." (Roy Mooney, SCOPE, June, 2008)

• Rifkin and Associates, Baltimore, USA

  Erik Rifkin

• Dept. of Geography & Environ. Engineering, Johns Hopkins University, Baltimore, USA

  Edward Bouwer

Erik Rifkin is the president of an environmental consulting firm that specializes in the characterization of ecological and human health risks from exposure to soil, water, air and sediments. His firm provides assistance and guidance to federal and state regulatory agencies and corporations regarding the nature and magnitude of environmental risks and potential remediation strategies. Dr. Rifkin's broad experience includes the communication of health risks and benefits to groups concerned with these issues. 

Edward J. Bouwer is Professor of Environmental Engineering at Johns Hopkins University in Baltimore, Maryland.  He has extensive experience with water and soil pollution and treatment.  His research provides guidance on defining and managing environmental risks and how to interpret human and ecological health risk data.  Dr. Bouwer has served on several National Research Council committees that provide guidance on managing human and ecological risks to Congress, regulatory agencies, and the scientific community.

Policies and ethics