Causal indicators

Fig. B.4 Computational causality indicating the direction of effort and flow...

Such an operational plan must have objectives and key performance indicators, as in the end it is measurement that matters. For this there must be targets set, not just improvement of performance. The Roadmap has to be part of target setting. In this regard it must be noted that ICAO s Business plan is on the right track, as it has all three types of indicators causal indicators - which relate to values and behaviours (which are known in other words as core competencies) output indicators - which measure performance in terms if efficiency and productivity and outcome indicators, which relate to the result or effect on clients and stakeholders. 

Epidemiological studies of nickel-producing and nickel-using workers seldom indicate excess mortaUty from nonmalignant respiratory disease. Evidence for such effects exists mainly as a few reports of isolated incidents of asthma, pulmonary fibrosis, chronic bronchitis, and emphysema in nickel workers. Nickel may or may not play a causal role in these incidents (131). 

Dose—response relationships are useful for many purposes in particular, the following if a positive dose—response relationship exists, then this is good evidence that exposure to the material under test is causally related to the response the quantitative information obtained gives an indication of the spread of sensitivity of the population at risk, and hence influences ha2ard evaluation the data may allow assessments of no effects and minimum effects doses, and hence may be valuable in assessing ha2ard and by appropriate considerations of the dose—response data, it is possible to make quantitative comparisons and contrasts between materials or between species. 

In a cross-sectional study, exposure and effect are studied simultaneously. This approach contains an inherent problem because exposure must precede the effect. However, it can he used to investigate acute effects and also mild chronic effects (which do not force people to leave their jobs) if exposure has remained rather stable for a long time. When the prevalence of the effects studied are compared with the prevalence in other worker groups (controls or references) which correspond otherwise with the study group but are not exposed to the agent investigated, indicative evidence of possible causality may be obtained. For example, cross-sectional studies have been applied successfully to reveal the associations between mild neurotoxic effects and exposure to organic solvents. ... 

In the future, the preventive tole of toxicology will be emphasized. It will be increasingly important to develop early indicators to monitor longterm subtle exposures that predict deleterious effects that are known to have a causal relationship with occupational exposures. In addition to collection of blood and urine samples, also collection of cells from points of... 

The intention of this section is to provide a selection of case studies of varying complexity and from different stages of chemical process plant operation. The purpose of these case studies is to indicate that human error occurs at all stages of plant operation, and to emphasize the need to get at root causes. The case studies are grouped under a number of headings to illustrate some of the commonly recurring causal factors. Many of these factors will be discussed in later chapters. 

In addition to the proactive uses of the SRK model described in the two previous sections, it can also be employed retrospectively as a means of identifying the underlying causes of incidents attributed to human error. This is a particularly useful application, since causal analyses can be used to identify recurrent vmderlying problems which may be responsible for errors which at a surface level are very different. It has already been indicated in Section 2.4.1 that the same observable error can arise from a variety of alternative causes. In this section it will be shown how several of the concepts discussed up to this point can be combined to provide a powerful analytical framework that can be used to identify the root causes of incidents. 

National initiatives in North America and Europe are designed to reduce pollution emissions from both stationary and mobile sources. Independently of whether they succeed in reducing pollutant loadings, the available evidence indicates that alterations in affected forests will continue. Obviously, no one knows what affected forests will be like in 50 years. There is little doubt that they will be different. And the sooner the anthropogenic causal factors - all of them - are reduced qualitatively and quantitatively, the better are the chances of retaining or regenerating forests that will have meaning and value for those who will want to use them. 

However, what is it about social status and social integration that makes them so important to health One proposal is that social status indicates social capital, and that it is a person s social capital which is most important to health. Wilkinson rejects this hypothesis, stating that social capital is an epiphenomenon and that we still have to identify the causal factors underlying it (Wilkinson 1999, p. 52). 

Wilkinson indicates that he considers social cohesiveness to be an epiphe-nomenon. The evidence shows that where income differences are greater, violence tends to be more common, people are less likely to trust each other, and social relations are less cohesive. However, the impression that social cohesion is beneficial to health may be less a result of its direct effects, and more of a marker for the underlying psychological pain of low social status . He believes that the biological causal pathways are Likely to center on the influence that the quality of social relations has on neuroendocrine pathways (Wilkinson, 1999, p. 48). 

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