Guest Editorial

The risk assessment: an intrinsic part of environmental health, public health – and life From the minute we wake up in the morning, we are faced with a barrage of hazards, and this continues throughout the day. Why are we not all dead then? Or so frightened that we daren’t get up at all? One reason may be that we have an internal protective system that processes these hazards and determines the risk – in other words, what is the likelihood that the hazard will cause harm. And very cleverly, we also make decisions about how we can avoid the hazard completely or control it. All this is an automatic response, which probably stems back from either experience or being told by our parents or others to take certain actions to avoid being harmed. For example, when I was 7 years old, my mother told me that she didn’t wish to scrape me off the road if I had a bike accident because I was going too fast downhill in the middle of our street. That vision is still imprinted in my brain to this day, and I took the necessary corrective action. Perhaps, then, we are all preprogrammed to be experts at risk assessment: we make decisions about many things on a day-to-day basis, based on whether we think the protective action is worth it. Risk assessment is an intrinsic part of environmental health and public health; in all aspects of our work, we ask the following questions: • What’s the hazard? • How likely is it to cause harm? • What should be done about it? • Which things absolutely must be done to prevent the hazard causing serious harm? It seems so simple, but it has taken many years and several disasters for these concepts to be formalised and put into legislation, guidance and policy.

The original research papers and opinion pieces collected in this issue provide examples of how risk assessment is working in the world of public and environmental health. In addition, it can be seen that when attempting to promote any form of public health message, it is critical that we consider the pre-existing beliefs of our audience because that will influence whether behaviour is changed. For example, Russell et al1 report that when attempting to get more girls to take up human papillomavirus (HPV) vaccination studies have shown that daughters will be influenced by their parents, and if those parents feel that by agreeing to vaccination they may be condoning promiscuity, then they may discourage uptake. Equally, the parents may be undertaking their own risk assessment as to whether the hazard is likely to occur, so, for example, intervention needs to also take this into account. The article from Stewart and Bourn2 on the evidence-based roles of the Environmental Health Practitioner shows how the Housing Health and Safety Rating System relies on a riskbased approach for the assessment and improvement of private sector housing, which now includes not only physical parameters, but recognises the importance of 29 hazards with a much broader remit, including psychological requirements and more health and safety issues than were considered previously. Mulvany et al 3 address the delivery of a national home safety equipment scheme in England, referring to the importance of assessing hazards in the home, and persuading occupiers to allow for home safety equipment to be fitted. Following a free home safety check, appropriate equipment could be installed by trained professionals, applying knowledge based on injury

statistics to select the equipment likely to make a difference – the selection of equipment therefore being based effectively on a risk assessment. The survey of scheme leaders of all local Safe at Home Schemes in socially deprived areas of England was undertaken, and one outcome shows again the importance of understanding how barriers to implementing controls arose; some families did not want to take up the offer of free equipment for a number of reasons, including worry of damage to their property and concerns about the equipment not looking very nice. A different form of risk assessment may be needed for schools, to determine whether the financial advantage of allowing commercial activities and marketing to take place in school outweighs the disadvantage that this may be detrimental to their pupils’ health or could undermine work carried out on the curriculum. The article from Raine4 also raises the concern that some business-sponsored teaching materials may be providing biased and misleading information, which may be inconsistent with the goals of health promotion in schools. Bloomfield5 shows the importance of a more rational approach to home hygiene, developed by the International Scientific Forum on Home Hygiene (IFH), known as ‘targeted hygiene’ – based on ensuring that critical points and times are targeted to block the spread of pathogens, while being more relaxed about visual hygiene. Again, a form of risk assessment is being carried out to determine which areas of the home need more attention. Barriers to behavioural change can be conflicting messages, as seen in Ackerley,6 and unsound media attention creating beliefs that we are ‘all too clean’.

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Guest Editorial MacAuslan7 also believes that there is a need for any advisory material for managers of small catering businesses to cover not only food safety, but ‘human factors’, behavioural issues, motivation, literacy and culture. Without understanding who we are advising, we will not be able to get the message across effectively. Finally, Gowland8 shows us how risk assessment again is necessary for businesses, enforcement officers and also consumers to ensure that allergens do not cause harm. Overall this issue shows clearly the breadth of the subjects within public health and environmental health, while demonstrating that at every turn in our professional and personal lives we are using risk assessment methods, but to change behaviour, we need to go further than simply giving information to

our target audience: we have to embrace the fact that humans are complex, and there are many factors affecting how we process such information and whether we take action on it.

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Dr Lisa Ackerley Visiting Professor of Environmental Health, University of Salford, Professorial Fellow of the RSPH, Managing Director of Hygiene Audit Systems Ltd

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References 1. Russell M, Raheja V, Jaiyesimi R. Human papillomavirus vaccination in adolescence. Perspectives in Public Health 2013; 133(6): 320324. 2. Stewart J, Bourn C. The environmental health practitioner: New evidence-based roles in

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housing, public health and well-being. Perspec­tives in Public Health 2013; 133(6): 325-329. Mulvany C, Watson M, Hamilton T, Errington G. Delivery of a national home safety equipment scheme in England: A survey of local scheme leaders. Perspectives in Public Health 2013; 133(6): 314-319. Raine G. Commercial activities and the promotion of health in schools. Perspectives in Public Health 2013; 133(6): 308-313. Bloomfield S. The hygiene hypothesis: Identifying microbial friends and protecting against microbial enemies. Perspectives in Public Health 2013; 133(6): 301-303. Ackerley L. Mixed messages in food safety: Killing us softly? Perspectives in Public Health 2013; 133(6): 296-298. MacAuslan E. Developing food safety cultures – Are small catering businesses being neglected? Perspectives in Public Health 2013; 133(6): 304-305. Gowland H. Reactions, regulation and risk: Protecting consumers with food allergies and intolerances. Perspectives in Public Health 2013; 133(6): 306-307.

November 2013 Vol 133 No 6 l Perspectives in Public Health  295 Downloaded from rsh.sagepub.com at University of Hawaii at Manoa Library on June 19, 2015

The risk assessment: an intrinsic part of environmental health, public health - and life.

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