The Illusion of Certainty

This book provides the reader with an understanding and appreciation of the risk assessment process and the ability to objectively interpret health risk values. Included is an explanation of the uncertainty inherent in the assessment of risks as well as an explanation of how the communication and characterization of risks can dramatically alter the perception of those risks. Risk statements tend to be presented as if they are authoritative, definitive, and based on clear and unequivocal evidence, which leads to the illusion of certainty. In this context, this book compares and contrasts the differences between risk assessment and causality. Case studies illustrate the strengths and limitations of characterizing certain risks. Using the accepted risk assessment paradigm proposed by the National Research Council, these case studies illustrate which risk values have merit and why other assessments fail to meet basic criteria.

Erik Rifkin is the president of an environmental consulting firm that specializes in the characterization of ecological and human health risks from exposure to soil, water, air and sediments. His firm provides assistance and guidance to federal and state regulatory agencies and corporations regarding the nature and magnitude of environmental risks and potential remediation strategies. Dr. Rifkin's broad experience includes the communication of health risks and benefits to groups concerned with these issues.
Edward J. Bouwer is Professor of Environmental Engineering at Johns Hopkins University in Baltimore, Maryland. He has extensive experience with water and soil pollution and treatment. His research provides guidance on defining and managing environmental risks and how to interpret human and ecological health risk data. Dr. Bouwer has served on several National Research Council committees that provide guidance on managing human and ecological risks to Congress, regulatory agencies, and the scientific community.

The Basics.- The Illusion of Certainty.- Cause and Effect vs. Risk Factors.- Reframing the Debate.- Assessing Human Health Risks from Environmental Contaminants.- The Sources of Uncertainty.- Case Studies.- VioxxTM and Heart Attacks.- Prostate Cancer Screening.- Elevated Cholesterol: A Primary Risk Factor for Heart Disease?.- Statins, Cholesterol, and Coronary Heart Disease.- Colorectal Cancer Screening.- Health Effects of Smoking.- Chlorination of Drinking Water and Health Risks.- Exposure to Residential Radon and the Risk of Lung Cancer.- Ecological Risk Assessment.- Asian Oysters in the Chesapeake Bay.- Chromium and Sediment Toxicity.- Perspectives.- The Physician's and Patient's Perspective.- Acceptable Health Benefits and Risks.