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INTRODUCTION

Risk refers to the likelihood that an untoward event will occur. Much environmental and occupational health research is directed at establishing whether an agent increases risk and by how much, laying the foundation for control. There are multiple evidence-based paths by which the risks posed by environmental and occupational agents are reduced and eliminated: regulatory actions directed at exposures, voluntary actions by those producing agents that pose a risk to the population and to workers, litigation directed at manufacturers and vendors of toxic agents, and protective measures taken by individuals and communities. Scientific evidence is central and often pivotal to motivating actions to reduce risk by providing: an indication as to the existence of a hazard; an understanding of the magnitude of the risk and how it varies with exposure or dose; and identifying points for interventions to reduce exposures and risks. Uncertainty, the complement to evidence, figures into decision-making as well. However, in actuality, numerous factors beyond scientific evidence and gaps in the evidence with attendant uncertainty drive actions related to policies on environmental and occupational agents (Fig. 78-1). These include stakeholder interests, the range extending from affected citizens and communities to the polluting parties. The power of political influence and of financial consequences of action need to be acknowledged, as does the impact of citizen’s voices and nongovernmental organizations. A single figure cannot capture the multiple sectors and their interactions across the broad array of regulations and stakeholders that drive environmental and occupational health. This chapter provides a general introduction to the management of risk in these sectors.

FIGURE 78-1

The weighing of evidence, uncertainty, and other factors in decision-making.

In the United States and globally, the regulation of exposures to environmental and occupational agents involves a patchwork of regulatory and nonregulatory approaches that have varied over time and differ to a substantial extent across nations. In the United States, there are enabling laws, for example, the Clean Air Act (Table 78-1), and agencies concerned with control of risks in specific domains: the Occupational Safety and Health Administration (OSHA), the Mine Safety and Health Administration (MSHA), the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA), and others. There are international bodies that offer guidelines on exposure limits, for example, the World Health Organization (WHO) and the International Labour Organization (ILO), but none has direct regulatory authority within nations. Their recommendations may be adopted as the basis for national standards, however, as with the WHO Air Quality Guidelines.1

TABLE 78-1MAJOR ENVIRONMENTAL LAWS IN THE UNITED STATES

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