Excerpt

The workshop on Environmental Health Sciences Decision Making was convened to inform the Roundtable on Environmental Health Sciences, Research, and Medicine on emerging issues in risk management, “weight of evidence,” and ethics that influence environmental health decision making. This is the first in a series of discussions for the roundtable to better understand the science needs in this area. The remarks in the workshop summary are the views of the individual presenters, panelists, or members and do not reflect a consensus of those attending or the roundtable.

This workshop focused on the strategies used to make decisions, whether they are based on the precautionary principle or cost-benefit analysis. During the initial session of the workshop (reflected in Chapter 1), the focus was on how complex decisions could incorporate new technologies and the need for a more interdisciplinary approach. The second session (Chapter 2) shifted the focus to the weights of scientific evidence and how this information is used in the decision-making process. The last session (Chapter 3) focused on the ethics and value of scientific information that is used for decision making. Speakers and participants discussed the issues of conflict of interest, bias, and transparency.

For the field of public health, identification of a hazard is only the first step in protecting individuals and the population at risk against its harmful effects. Earlier strategies focused on one chemical at a time and often assumed that individuals are static in the environment, so that their behaviors and lifestyle choices were not taken into account. However, as understanding of toxicology and epidemiology has evolved, so has scientific understanding of the complexity of environmental hazards. Risk assessment has moved beyond the general assumption that a major cause of a problem (exposure) can easily be identified and a solution generated. Thus, according to some of the workshop participants, society is currently at a crossroads in environmental health decision making, and there is a need to look at the paradigm very carefully and think about what science can do to improve the way those decisions are made.

Contents

• The National Academies
• Roundtable on Environmental Health Sciences, Research, and Medicine
• Reviewers
• Preface
• Summary
  • HOLISTIC APPROACH TO ENVIRONMENTAL HEALTH DECISION MAKING
  • ALTERNATIVE VIEW TO ENVIRONMENTAL HEALTH
  • BEYOND PRECAUTION
  • WEIGHING EVIDENCE
  • REVISITING ENVIRONMENTAL HEALTH DECISIONS
  • ETHICS OF CONFLICTS OF INTEREST
  • PERSPECTIVES ON ENVIRONMENTAL HEALTH DECISION MAKING
• 1. Approaches to Decision Making
  • HUMAN–ENVIRONMENT NETWORK: CHALLENGES TO ENVIRONMENTAL HEALTH
  • ALTERNATIVES ASSESSMENT AS A STRATEGY FOR DECISION MAKING
  • BEYOND PRECAUTION
• 2. Scientific Issues in Environmental Health Decision Making
  • EVALUATING WEIGHTS OF EVIDENCE FOR DECISION MAKING
  • THE ROLE OF UNCERTAINTY AND SUSCEPTIBLE POPULATIONS IN ENVIRONMENTAL HEALTH DECISION MAKING
  • THE USE AND MISUSE OF SCIENCE IN DECISION MAKING
  • RATIONALE FOR REVISITING AN ENVIRONMENTAL HEALTH DECISION: THE NATIONAL TOXICOLOGY PROGRAM
  • SESSION DISCUSSION: WEIGHT OF THE EVIDENCE IN SCIENCE VERSUS LAW
• 3. Conflicts of Interest, Bias, and Ethics
  • GENERAL OBSERVATIONS REGARDING CONFLICTS OF INTEREST
  • MANAGING CONFLICTS OF INTEREST: THE INTERNATIONAL AGENCY FOR RESEARCH ON CANCER
  • SESSION DISCUSSION: CONFLICTS OF INTEREST IN THE CURRENT RESEARCH CLIMATE
• 4. Stakeholder Perspectives on Environmental Health Sciences Decision Making
  • FULL DISCLOSURE OF CONFLICTS OF INTEREST
  • THE CREDIBILITY OF SCIENCE
  • ASYMMETRY IN DECISION MAKING
  • DATA DEVELOPMENT FOR RISK ASSESSMENT
• 5. General Workshop Discussion
  • TRANSPARENCY
  • THE CONTEXT AROUND CONFLICT AND EVIDENCE
  • CODE OF ETHICS
  • FUTURE DIRECTIONS
• 6. Closing Comments
• References
• Appendixes
  • Appendix A Workshop Agenda
  • Appendix B Speakers and Panelists
  • Appendix C Workshop Participants

Rapporteurs: Yank Coble, Christine Coussens, and Kathleen Quinn

Support for this project was provided by the National Institute of Environmental Health Sciences, National Institutes of Health (Contract N01-OD-4-2193, TO#43); National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention (Contract No. 200-2000-00629, TO#7); National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (Contract 0000166930); National Health and Environment Effects Research Laboratory and the National Center for Environmental Research, U.S. Environmental Protection Agency (Contract 282-99-0045, TO#5); American Chemistry Council (unnumbered grant); ExxonMobil Corporation (unnumbered grant); and Institute of Public Health and Water Research (unnumbered grant).

Suggested citation:

IOM (Institute of Medicine). 2009. Environmental Health Sciences Decision Making: Risk Management, Evidence, and Ethics: Workshop Summary. Washington, DC: The National Academies Press.

The views presented in this book are those of the individual presenters and are not necessarily those of the funding agencies or the Institute of Medicine.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.