HEALTH RISK ASSESSMENT

Outline

• Understanding risk
• What is health risk assessment
(HRA)
• Qualitative HRA
• Quantitative HRA

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 Classification of Risk
• Voluntary risk :
e.g. smoking, alcohol- overconsumption,
occupational hazards, diet-induced diseases

• Involuntary risk :
e.g. environmental pollution, communicable
diseases, environmental disasters, natural
disasters, war casualty, road accidents,
industrial accidents.

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 Video : https://youtu.be/qo5P9zvM59A

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 Health Impact
Assessment
The process of estimating the potential
impact of a chemical, biological, physical or
social agent on a specified human
population system under a specific set of
conditions and for a certain timeframe.

Source : EnHealth Council (2001). Health impact assessment

guidelines. Canberra : Commonwealth Department of Health and
Aged Care, Australia.

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 What is HIA?
• HIA assesses the health impact of a
development project, programme or policy.
• HIA can be retrospective, concurrent or
prospective (as in EIA).
• HIA is now considered mandatory for many
detailed EIA projects
• In the Guidance Document on HIA in EIA, the
focus is on prospective HIA as it applies to
EIA.
• Health risk assessment (HRA) is a
tool for HIA.
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Health Risk and Impact Assessment Framework
 Steps in HIA
• Screening
• Scoping
• Appraisal of the potential
health impacts (including
health risk assessment)
• Decision-making
• Monitoring and evaluation
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 Health Risk Assessment
Health risk assessment is a methodological
approach in which the toxicities of a
chemical are identified, characterized,
analyzed for dose-response relationships,
and the data generated are applied to a
mathematical model to produce anumeric
estimate representing a guideline or
decision concerning allowable exposure.
Source : James, R.C. 1985. Risk assessment. In : Williams, P.L. and Burson,
J.L. Industrial Toxicology. New York : Van Nostrand Reinhold.
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Steps in Health Risk Assessment
According to the National Academy of Sciences :

• Hazard identification : characterization of innate

adverse toxic effects of agents.
• Dose-response assessment : characterization of the
relation between doses and incidences of adverse
effects in exposed populations.
• Exposure assessment : measurement or estimation
of the intensity, frequency, and duration of human
exposures to agents.
• Risk characterization : estimation of the incidence of
health effects under the various conditions of
exposure.
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 Science Science policy Policy
Facts Judgments Values
RESEARCH NEEDS AND PRIORITIES

Scientific Research
 Epidemiology Risk Assessment Risk Management
 Clinical Studies Dose-Response Economic No Action
Assessment Issues D
 Animal Toxicology Research E Information Programs
Needs Risk
 Cell/Tissue Experiments Hazard Charazterization C Economic Incentives
Identification Legal Issues I
 Computational Methods S Ambient Standards
Social Issues
 Monitoring/Surveillance Exposure I Control Devices
Assessment Political Issues O
N Emission Limitations
Engineering Issues
S Ban
SCIENTIFIC INFORMATION AND
UNDERSTANDING

Research Risk assessment Risk management

 Develops factual basis  Estimates magnitude, likehood, and uncertainty  Integrates risk assessment with other issues
 Explicitly considers personal and societal uncertainty of risk  Determines acceptability of risk and appropriate
values  Requires scientific judgments and policy responses
choices  Emphasizes values in selection of policy options

Figure 3. An alternative risk assessment paradigm and its relationship to the fact-value
continuum. Adapted from Sexton et al.
Source : Sexton, K. 1995. Science and policy in regulatory decision making : getting the facts right1a1bout
hazardous air pollutants. Environ. Health Perspective, 103 (Suppl. 6) : 213-221.
 Hazard Identification
• Identification of the type of
hazards (biological, chemical
and physical).
• Recognition of hazard
sources or reservoirs.
• Understanding the modes of
hazard transmissions.
• Describing the toxicity
characteristics of hazards.
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Dose-Response Assessment
• Characterization of the relationship
between increasing dosages of a
hazard and its corresponding adverse
effects.
• Dose-response data are mainly derived
from animal toxicity testings.
• Human data are available from
epidemiological data and environmental
catastrophe.
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 Exposure Assessment
• Exposure is the contact of a
biological, chemical or physical
substance with the outer boundary
of an organism.
• Exposure assessment is the
determination or estimation of the
route, magnitude, frequency, duration
of exposure, and characteristics of the
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exposed population.
 Risk Characterization
• To integrate and summarize the
hazard identification, dose-response
assessment, and exposure
assessment procedures, in order to:
• Develop a numerical risk estimate
for the hazard assessed.
• Present assumptions, uncertainties,
and scientific judgement pertaining to
the hazard assessed.
• Define significance of estimated risk.
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 Qualitative Risk Assessment
It merely characterizes or compares the
hazard of a chemical relative to others,
or defines the hazard in only qualitative
terms, such as mutagen or carcinogen,
which connote certain risks or safety
procedures, and as such may not
necessarily require a numerical
assessment of risk.
Source : James, R.C. 1985. Risk assessment. In : Williams, P.L. and Burson, J.L.
Industrial Toxicology. New York : Van Nostrand Reinhold.
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 A Qualitative Risk Assessment Matrix

Source : Clemens P.L. and Simmons R.J. 1998. System safety and risk management : A guide for engineering educators. Cincinnati :
21 National Institute for Occupational Safety and Health, U.S. Department of Health and Human Services.
 • Code 1 : Imperative to suppress risk to a lower level.
• Code 2 : Operation requires written, time-limited waiver, endorsed by management.
• Code 3 : Operation permissible.
• Personnel must not be exposed to hazards in Risk Zones 1 and 2.

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 Environmental Health Risk Matrix

Risk rating = Ʃ (hazard rating) × Ʃ (exposure rating)

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 Hazard Risk Probability and Severity

Note : Adopted from the risk assessment matrices of MIL STD882B (1993)1, WHO/FAO (2009)2, and
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Department of Health, Government of Western Australia (2010) 3.
 Hazard Rating Score

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 Exposure Rating Score
Level 4 3 2 1
Population profile/ Residential Hospital/ School Recreational
Population density Educational
institution
5 >1,501 persons per km2 9 8 7 6
4 1,001-1,500 persons per km2 8 7 6 5

3 501-1,000 persons per km2 7 6 5 4

2 101-500 persons per km2 6 5 4 3
1 <100 persons per km2 5 4 3 2
0 No population 0 0 0 1

Note : For a sub-district with no population living there, an exposure rating score
of 1 is given as there is possibility of outsiders coming to the sub-district for
recreational purposes.
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 Risk Rating Score

Risk rating = Ʃ (hazard rating) × Ʃ (exposure rating)

Acceptable risk = Risk rating of < 2,000
Unacceptable risk = Risk rating of 2,000 and above

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Quantitative Risk
Assessment
It generates a numerical
measure of the risk or
safety of a chemical
exposure.

Source : James, R.C. 1985. Risk assessment. In : Williams, P.L. and Burson, J.L.
Industrial Toxicology. New York : Van Nostrand Reinhold.
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 A multi-source, multi-media, multi-exposure pathway

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 Acceptable risk
• Definition of acceptable risk :
 For non-carcinogenic effect, as a hazard
quotient (HQ) of less than 1.
 For carcinogenic effect, a lifetime cancer risk
(LCR) of between 10-6 to 10-4 is acceptable. Risk
> 10-4 is clearly unacceptable, while risk < 10-6
is clearly acceptable.
• Risk acceptability is a public concept and demands
that the public be informed of the level of risk
involved.

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Thank you