Animal Waste, Water Quality and Human Health

Comparative risk analysis 367would be derived in a qualitative approach and uses risk ‘scores’ to construct ametric for comparing the magnitude of risks from different pathogens, sourcesand exposure locations. As such it calculates relative health risks and attemptsto quantify the relative magnitude of risks. Typically, this uses thefundamental notion that “risk = likelihood of exposure × consequences”. Scoresfor “consequences” may be broken into sub-metrics for scale, magnitude ofexposure and probability of illness, duration and severity of adverse healtheffects. The outcome can be somewhat dependent on the assignment of scoresand the definition of boundaries between them.Quantitative Microbial Risk Assessment (QMRA, Haas et al. 1999) attempts tocalculate absolute health risks. Whilst ‘deterministic’ approaches are sometimesused, QMRA usually estimates risk by considering many possible combinations,via statistical or ‘stochastic’ modelling of exposures and dose-response. As suchit is much more data-intensive than the comparative approach, particularlybecause it requires data on the variability over time of the degree of pathogencontamination at exposure locations.In deterministic approaches to risk modelling, risk (or relative risk) is evaluatedon the basis of representative values of the risk-affecting variables. The values maybe the average, or mode, but to generate conservative estimates of risk, values thatare deliberately conservative (e.g., the value that will not be exceeded in 95% ofcases) may be used (use of a maximum value is not favoured, because it isalways possible that it may be exceeded). This is done so that when the model iscalculated to evaluate the risk, the estimate is inherently conservative. Decisionsbased on that estimate provide a high degree of public health protection, butthese estimates may be unrealistically high and lead to poor decisions. 4 Otherpotential consequences of employing a deterministic approach, compared tostochastic modelling, were exemplified in Nauta (2000) showing the failure toconsider variability in risk assessment modelling could lead to erroneous riskmanagement decisions.For reasons such as those described above, a stochastic simulation modellingapproach is often used to be able to better represent and assess the influenceof variability in the various elements and circumstances known to influence4A problem with this approach is that in making a series of conservative simplifying assumptionsthe conservatism compounds and decisions based on the approach represent a level of risk thatonly occurs in very rare sets of circumstances, rather than being more representative of the riskfrom the “normal” situation, but with allowance for rare events. This problem was explained, andits implications discussed, by Cassin et al. (1996) who coined the term “compoundingconservatism” to describe it.