Health risk evaluation process

The health risk evaluation process consists of four steps hazard identification, dose-response assessment or hazard assessment, exposure assessment, mid risk cliaracterization. 

Figure 9.2.1. Tlic Health Risk Evaluation Process...

Health risk assessment is defined as tlie process or procedure used to estimate tlie likelihood that humans or ecological systems will be adversely affected by a chemical or physical agent under a specific set of conditions. Tlie health risk evaluation process consists of four steps hazard identification, dose-response assessment or liazard assessment, exposure assessment, and risk characterization. 

To avoid the damage of human health and contamination of particular elements of the environment it is necessary to apply the risk management process which is significant and still rmderrated tool in the Czech Republic. No matter the characteristic and sector classification of the researched risk in the risk evaluation process it is possible to identify common elementary steps like the risk resources identification, to evaluate, to semi-quantify or quantify all risks, to propose and then to implement adequate preventive countermeasures for the critical risks. Within the waste disposal process in this phase this method must be applied, i.e. in the phase of a landfill planning, operations and closing. Just only in this was it is possible to reach an efficient risk control and reduction. 

After each issue outlined in the evaluation criteria has been developed for each corrective measure, the selection of the most appropriate alternative can be made. Trade-offs among health risks, environmental effects and other pertinent technical, environmental and human health factors enter into this decisionmaking process. In the RCRA context, cost is not a factor in the selection process except when two or more corrective measure alternatives are determined by EPA to provide similarly adequate levels of protection of human health and the environment. 

The first step is to identify the substances present at the workplace. As a starting point, knowledge of the process is needed in order to formulate a list of all chemical agents used in the establishment. The list should include not only primary products but also intermediate and final products, as well as reaction products and by-products. For the chemical agents in the list, it is necessary to know their chemical properties, especially hazardous ones their OEL values, including biological limit values and, where these are not available, other technical criteria that can be used to evaluate the risk. It is also helpful to include any information on the safety and health risks of those substances provided by the supplier or other readily available sources. This information on dangerous substances and preparations, in the form of safety data sheets, is intended primarily for industrial users, to enable them to take the measures necessary to ensure the safety and health of workers. 

The process for assessing environmental health risks Is complex Information regarding 1) the environmental agent, 2) the pathways by which exposure occurs, and 3) the biologic effects observed after exposure must be assembled and simultaneously evaluated Incomplete knowledge or Inadequate methodology In any of these three areas can severely Inhibit accurate or useful estimates of health risk ... 

Significance of the predicted impacts should be assessed in the process of impact evaluation or interpretation. At this stage the health risk estimates (quantitative and qualitative) are analyzed in terms of their acceptability against relevant regulatory and/or technical criteria environmental quality standards or exposure limits. 

H. Gregor Rigo attended Ohio University and earned his Ph.D. in mechanical and environmental engineering from the University of Illinois. He is currently president of Rigo Rigo Associates, Inc., in Berea, Ohio. He has extensive experience in plant start-up, process and environmental engineering, and applied statistics focused on the use and control of emissions from nontraditional fuels technical, environmental, and economic evaluations and multipathway health risk assessments. 

Depending on the needs of the individual pharmacy, several different types of insurance policies may be required to provide adequate risk protection for the business. The geographic location, type of practice, and services offered will influence the types of insurance needed. The risk management process is a continuous process, and periodic evaluations are necessary to address new or emerging risk threats to the pharmacy. Emerging threats discussed later in this chapter exemplify how recent changes in health care practices (privacy issues) and technology create new and different risk threats to the pharmacy. 

Risk evaluation in the assessment process focuses on weighing the health and environmental threats posed by an identified hazard. First, the possibility and probability that a person will actually experience an adverse effect as a result of the existence of the environmental hazard and exposure to it must be weighed and, secondly, the number of persons who might be exposed must be considered. 

Because the literature describes several limitations in the use of NOAELs (Gaylor 1983 Crump 1984 Kimmel and Gaylor 1988), the evaluative process considers other methods for expressing quantitative dose-response evaluations. In particular, the BMD approach originally proposed by Crump (1984) is used to model data in the observed range. That approach was recently endorsed for use in quantitative risk assessment for developmental toxicity and other noncancer health effects (Barnes et al. 1995). The BMD can be useful for interpreting dose-response relationships because it accounts for all the data and, unlike the determination of the NOAEL or LOAEL, is not limited to the doses used in the experiment. The BMD approach is especially helpful when a NOAEL is not available because it makes the use of a default uncertainty factor for LOAEL to NOAEL extrapolation unnecessary. 

Identifying a hazard is only a small part of the risk assessment process. Hazard must be differentiated from risk. Assessing risk involves an analysis of the likelihood that adverse effects to human health or the environment after exposure to a chemical may occur. For risk management, exposure assessments therefore play equal (if not more) important parts as evaluations of hazard. The following sections discuss how toxicology, exposure assessments, and risk characterisations contribute to the central scientific definition of risk as probability versus consequence [93-95]. 

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