Cass Sunstein, Risk, Cost-Benefit and OHS – Part 2

Part 2 of Risk & Reason book review from SafetyAtWork magazine 2003

review-4i11-2

Sunstein closes the chapter “Thinking About Risks” with a short reference to September 11 2001 with which he says that “acts of terrorism show an acute appreciation of the psychological phenomena..”

Throughout the book, there are snippets that can be related to safety management.  For instance, he writes of “dreaded deaths” with 3 points:

  1. People can adapt to suffering much better than they think they can.
  2. Some pain and suffering may well be an inevitable part of a desirable period in which people…can plan and adapt themselves to the fact of death…(p.66)
  3. The period of pain and suffering that precedes death ought… to be far less important… than the fact of death itself.”

These points relate to HIV and cancer principally, but can’t we obtain some constructive advantage from having our employees dread workplace or traumatic deaths?   First aid training often raises safety awareness because the First Aiders dread having to apply their skills.  We drive cautiously because we dread traumatic injuries to our family and ourselves.  Dread can lead to caution which leads to safe work.

Sunstein chooses not to deal with the relationship between risk and culture and directs us to “Risk & Culture” by Douglas and Wildavsky (1992).  It is fair to acknowledge intellectual limitations but the whole book operates through, predominantly, the concerns of the United States culture and values.  The cultural values of the US are not universal and some admission of this variation would have been useful, particularly given that the Douglas and Wildavsky book was published well over 10 years ago.

The illustration of eight propositions for cost-benefit analysis and government decision-making is very useful.   They support the integration of qualitative measurements and a broad application of “costs”.   One proposition is that “agencies should be required to show that the benefits justify the costs.  If they do not, they should be required to show that the action is nonetheless reasonable…” Accountability is now an essential element of all business areas.

Risk and Reason may prove to be invaluable to United States readers but information for others was difficult to extract.  (The testimonials on the dust jacket are glowing but are all academic, although one is from outside the US).   There is no obligation for writers to include readers outside of their own marketplace but on an issue like risk and in a context of environmental management, it is disappointing that the book does not acknowledge the global readership.   As mentioned above even very well known risk experts are not even referenced.   The book is parochial and does not acknowledge that international standards do affect the US legal system even if it is less than in other jurisdictions.  Environmental issues cross territorial boundaries and are becoming more involved with global legal structures and obligations.

Cass Sunstein has a good writing style and it is not difficult to read.  We can only hope that the publishers encourage Mr Sunstein to write a complementary book focussing on risk and reason outside the United States.

The best pathway to Cass Sunstein information and writings is through his listing at Wikipedia.  However, I did enjoy reading this article.

Cass Sunstein, Risk, Cost-Benefit and OHS

On 26 January 2009, the Los Angeles Times reported on the appointment of Cass Sunstein as the “regulatory czar” under Barack Obama’s presidency.  He is to be appointed the head of The Office of Information and Regulatory Affairs.

In 2003 in the precursor to the SafetyAtWorkBlog, SafetyAtWork magazine, I reviewed Sunstein’s book – Risk & Reason, Safety, Law and the Environment.  Below is the first part of that review

SafetyAtWork magazine Vol 4 Issue 11 - 2003
SafetyAtWork magazine Vol 4 Issue 11 - 2003

So many safety professionals also have responsibility for the environment that Risk & Reason – Safety, Law, and the Environment seemed an attractive read.  This book is unashamedly North American and to some extent that is a discouragement but given that many innovations originated there, the book was worth a look.

From outside North America the issues of most relevance were those concerning risk perception and the role of experts.  Cass Sunstein states that

Before government acts, it should, if feasible, attempt to produce a cost benefit analysis, understood as a detailed accounting of the consequences of the alternative courses of action.  The cost benefit analysis should allow people to see if the problem at issue is small or large.  It should explore the expense of reducing the problem and explain who will bear that expense.  (p. ix)

He says that,

Some people think of cost benefit analysis as a form of cold, barely human calculation, treating health and life as mere commodities and envisioning government as some kind of huge maximizing machine.  On the contrary, I urge that cost-benefit analysis should be seen as a simple pragmatic tool, designed to promote a better appreciation of the consequences of regulation.  (p.ix)

I wondered whether what he considers cost -benefit analysis in the broadest sense.  His concepts fit with risk management and, of course, risk management is supported by various standards such as AS4360.

The trap with cost-benefit analysis is that decisions made are cold and barely human, which he acknowledges.  He uses the fuel economy standard as an example.

If, for example, proposed fuel economy standards will significantly reduce greenhouse gases but also lead to smaller and less safe cars -and thus produce over a thousand extra deaths each year – officials and citizens should be aware of that fact.  (P. ix)

Here is a crucial question for the book – what is the more important, the needs of the many, or the needs of the few.  In his introduction, he surprisingly uses an example of the Hatfield rail crash in the United Kingdom.  Sunstein discusses how people now perceive rail transport as unsafe and began driving to work, a far more statistically dangerous activity.  This example is proceeding well until he stumbles.  He says that

After the crash, people undoubtedly spoke with one another about their fears, creating a kind of cascade of concern about train safety. We shall also see that cascade effects can lead people to large-scale errors about risks. But government regulation, my principal topic here, was not involved. (p 2)

It is clear that Sunstein is not as well informed on Hatfield as is necessary to use the example. Government regulation, or deregulation, of rail transport has never sat well with the English rail traveller.  Hatfield confirmed fears encouraging people to alternative transport methods, ones over which they have direct control.  With train travel, you place your trust in the driver and the system. In automobiles, you feel in more control.

Sunstein makes three recommendations to government on assessing regulation through cost-benefit analysis:

  • “…attempt to assess the magnitude of any problem that it is attempting to solve, through quantitative assessments to the extent possible.”
  • “…attempt to assess tradeoffs, by exploring the costs of regulation, also in quantitative terms if possible.”
  • ”   attempt to use tools that are effective and inexpensive.” (p.5)

This process would be familiar to all safety professionals. We recommend the same process to improve safety:

  • Identify
  • Assess
  • Control

This book shows that there are many parallels between environmental regulation and OHS regulation. Sunstein says

“Properly understood, a cost-benefit state attempts to make people’s lives better. The effort to quantify and to balance is designed not to assess everything in terms of money but to promote close attention to the actual consequences of what government does.” (p.8 )

Chapter 2 is very much about risk perception but suffers from not drawing more on the large amount of safety risk perception analysis and terminology. Sunstein reaches the issue of risk perception from a different point of origin. He asks,

‘What are ordinary people thinking? Can we discern some structure to their judgments? Three beliefs seem to be playing a large role. First, many people believe that risk is an “all or nothing” matter. Something is either safe or dangerous, and there is no middle ground. Second, many people are committed to a belief in the benevolence of nature. They think that the products of human beings, and human activities, are more likely to be dangerous than the products of natural processes. Third, many people subscribe to the “zero risk” mentality, at least in some domains. Such people believe that it is both possible and appropriate to abolish risk entirely, a belief that appears closely connected with the notion that risk is a matter of “all or nothing.”‘ (p.36)

Sunstein discusses Outrage without naming it and by missing this concept narrows the relevance of the book and the authority of his voice. If he had looked at any of Peter Sandman’s work on Outrage, had looked to other scholarly fields, his work would have been more authoritative. Given that Sandman’s works originated from environmental and planning issues it is very surprising that there is no reference to them, particularly given that Sandman is also a United States academic.

Sunstein says that “a possible conclusion is that, with respect to risks, vivid images and concrete pictures of disaster can ‘crowd out’ other kinds of thoughts, including the crucial thought that the probability of disaster is very small.” (p.46) How much more interesting would it have been if he had incorporated Sandman’s Outrage principle and expanded upon it?

The next part of this review will be posted tomorrow.

Those at risk of exposure to asbestos

Over this last weekend, asbestos-safety advocates, ADSVIC, took advantage of the topicality of the navy’s poor management of asbestos by including half-page ads in major Australian newspapers.  The ads focused on the risks associated with DIY home renovators but law firm, Slater & Gordon, related their asbestos information sheet directly to the media attention about the Australian Navy.

Slater & Gordon, a former employer of Australia’s industrial relations and education minister, Julia Gillard, have always been active in seeking new clients and have participated in many class actions based on workplace safety issues, particularly the James Hardie Industries legal action of earlier this century which was important for many reasons, including the furthering of political careers.

Slater & Gordon’s information sheet includes a list of those people who it believes are at risk of asbestos-related diseases.  It doesn’t much leave room for anyone to feel safe from this risk.

  • Miners
  • Asbestos plant workers
  • Handlers and waterside workers
  • Asbestos factory workers
  • Carpenters, plumbers, electricians and builders
  • Wives and children of workers
  • Office workers
  • Mechanics/brake workers
  • Power plant workers/refinery workers
  • Teachers and students
  • Hospital workers
  • Telstra workers
  • People at home

Kevin Jones

The reality of First Aid

Many employees undertake first aid training because it is a relatively easy training program to arrange, it is cheap and it provides skills that can be applied outside the workplace.  

But newly trained first aiders often leave training with an unrealistic feeling of empowerment.  Regularly, small businesses regret the disruption caused by the first aider’s evangelism for safety, particularly if the first aider was trained to provide some generalist safety presence in the company.  Similar disruption can result from health and safety representative training and perhaps that is why many small businesses are wary of this.

First aid trainers need to remind students regularly of the reality of first aid.  This reality is shown in the death of a truck driver in an isolated part of Australia on 9 January 2009.  First Aid is a terrific life-saving skill but the reality is that circumstances beyond one’s control may still result in a death.

In a class once, a student asked a first aid instructor what would happen if a farmer was bitten by a snake in an isolated part of the farm and the farmer  had no first aid skills or kit.  The trainer responded, “the farmer would die”.

The reality of living in a large country of isolated roads and small population is shown in the death of the truck driver.

The role of mobile telecommunications in the article is a distraction and relates more to the current political and commercial disputes between the Australian government and the telecommunication providers, than to the truck driver’s injuries.  

The article may lead to discussion on the poor emergency resources in rural and outback Australia.

First aid and emergency response has been revolutionised by mobile phone technology over the last 20 years.  Mobile phones have caused us to find lost bushwalkers and to get emergency ambulances to accident scenes much quicker.  Thankfully, a quicker emergency ambulance response shortens the time needed applying first aid.

It is a truism that no matter how much training we have, or how much technology we can access, death is a reality of life.

Safety challenges for English pantomime

Today, the UK Daily Mail published an example of the mish-mash of safety management problems that are confusing the public about what an OHS professional does.

An amateur Christmas pantomime is confused by the plethora of safetyand health obligations being placed on them by, it is assumed, a variety of regulators.  Let me speculate on what may be behind some of the issues.

“scenery is free from sharp edges” – a good set designer, even an amateur one, should already have this aim as part of their skills.  Backstage in theatrical productions is notoriously dark and often full of people, round the edges of scenery is not an unreasonable expectation.

The theatre company chairman says that the facility is not the best.

“Mr Smith, 59, a training manager, also claims that Brierley Hill Civic Hall’s backstage facilities are ‘poorer than Cinderella’s kitchen’ making it all the more difficult to meet the health and safety requirements.”

Ice cream and milk temperature is a matter of food safety.  These can easily be managed by the facility manager providing suitable refrigeration.  If the facility is a regular venue for theatrical productions it is not unreasonable to expect the venue to be fit-for-purpose.  Graeme Smith says that the company has already solved the issue to some degree:

“The 100-strong am-dram group, which was first formed 60 years ago, has also bought a freezer because it does not trust the reliability of the venue’s, Mr Smith said”

Clearly, Mr Smith has as many problems with the venue as he does with the safety needs of his production.

Climbing a beanstalk with a harness – many theatrical productions have incorporated harness into aerial effects or revised their sets and direction to depict climbing without physically climbing 30 feet.  This is a pantomime and it involves acting so act like you’re climbing a beanstalk.

Chaperoning children – mothers of stage children have been doing this for years.  The nature of backstage may require supervision of children to reduce the hazards of dozens of excited children causing problems and creating hazards for other stage workers.  Depending on the layout of the facility the dressing rooms may some way from the stage, perhaps through public areas, and supervision is not an unreasonable expectation.

“do not enter the props storage area” – all workplaces have areas that restrict unauthorised access for good reason.  Supervision may be the best available control measure for the circumstances.  The article refers to pyrotechnics.  If these were to be used in this production and the pyrotechnics were stored in the props area, entry restriction would be more than reasonable.

“inform the audience before the performance if pyrotechnics are to be used.”  It is peculiar that the audience is informed as pyrotechnics should be configured to operate with no risk to audience, actors, or stage staff.  If the reason for this advice is fire safety, then this relates again to the suitability of the facility itself, to fireproofing, fire exits etc.  Given the fires that have resulted from unsafe use indoors of pyrotechnics over the last few years, increased warnings seems appropriate.

I am not sure about the need to identify curtain users but the need to prevent people falling into the orchestra pit is obvious.  It is implied that this would only occur outside of productions and rehearsals and, in that case, this would be the responsibility of the facility manager.  Boarding up the pit may be an excessive control measure and alternative barriers may be appropriate.  Again this also relates to the initial design of the facility.

There are enough hints in the article to show that the suitability of the Brierley Hill Civic Centre for theatrical productions needs to be reviewed.  Many of the theatre company problems seem to be to accommodate design and layout deficiencies.

The Australian theatrical union issued safety guidelines for live theatre productions in 1999

The HSE and the Association of British Theatre Technicians has safety guidelines on pyrotechnics  and a range of other publications related to theatrical productions.

Clearly there is no “idiot’s guide to amateur productions” but there may be a need for such a publication.  The experience of the Brierley Hill Musical Theatre Company shows how one small event can be bombarded by attacks from all sides when all the company wants to do is put on a pantomime.  Theatrical productions have always been big management challenges and health and safety has always been part of this process. 

It was a fantasy sixty years ago when Judy Garland and Mickey Rooney could put an elaborate stage show together overnight in the movies. It remains a fantasy.

Kevin Jones

“Illegal” asbestos use in the Australian Navy

The defence forces operate with a different understanding of risk and safety.  In the past there are many instances where soldiers lives have purposely been sacrificed for the greater good.  This has been an integral part of many “heroic” battles. 

The Australian federal OHS authority, Comcare, is at the forefront of a clash between occupational safety and armed services culture.  The Age newspaper has revealed the Australian navy’s continued use of chrysotile asbestos in its ship and navy bases years after the substance was banned for use.  The newspaper says that a risk assessment report has found

..”the risk to personnel was significant, exposure to asbestos was almost certain and the consequences were “potentially catastrophic”.”

OHS standard practice is to identify the control of hazards in line with the Hierarchy of Controls which seems to have been done as the newspaper reports

“A ban on the use of and import of asbestos-containing materials in Australia came into force on January 1, 2004. But the ADF [Australian Defence Force] requested and won an exemption [page 5 of the SRCC 2005-06 Annual Report] to continue using chrysotile asbestos parts until 2007 on two strict provisos: that the parts were “mission-critical” – meaning their absence would ground equipment and jeopardise a mission – and that no non-asbestos replacement parts could be found.”

So the hazard can’t be eliminated or substitutes found.  That’s the first two levels of the hierarchy down.  The report goes on to assert that the (in)action of the Navy could be illegal and says the exemptions were renewed for another three years (page 81 of the SRCC Annual Report 2007-08)

The remaining levels of the control hierarchy are not addressed in recent media reports or documents available through Comcare’s website but the continuing cases of asbestos-related diseases reported by the lobby groups would indicate that personal protective equipment may not have been used or used appropriately. 

Most organisations are aware of the hazard of asbestos if not how the hazard relates to the specific circumstances.  The Navy cannot claim this as it has specifically claimed exemptions for the hazard. 

The current Defence Minister, Joel Fitzgibbon, took action on the defence force’s use of asbestos products almost 12 month’s ago and even though it was reported that he gave the Defence chiefs a “dressing down” over the issue, circumstances seem not to have improved. 

“But Defence Minister Joel Fitzgibbon, who first accused the Defence Force of lethargy in its efforts to remove asbestos in 2007, when he was in opposition, said despite the massive cost of ridding the ADF of asbestos, its continued use was unacceptable.”

For those who habitually argue that worker safety is not affordable, the Minister’s quote above shows commitment.  Sadly it is these types of comments that can come back and haunt politicians.

It is suspected that the Minister or the Navy is receiving letters about non-asbestos gaskets from keen equipment suppliers as you read this blog.  But that raises the problem of the labyrinthine issues of defence equipment procurement.  Perhaps the fact that anti-asbestos campaigner and former trade union leader, Greg Combet, is now the Parliamentary Secretary for Defence Procurement may fast-track the issue.  It is hoped that on the issue of asbestos in the defence forces, Greg speaks up soon.

Kevin Jones

Defibrillators in public places

official20portrait_oct07_sm-brumbyThe Victorian Premier, John Brumby, “unveiled” publicly accessible defibrillators at the Southern Cross station in Melbourne on 6 January 2008.  Australia has been relatively slow in the take-up of defibrillators as part of the non-professional first aid role.  Partly this was due to the initial expense of each unit but also because workplace first aid legislation took some time to accommodate technology.

In most States of Australia, this was exacerbated by the emphasis on allocating first aid resources on the basis of need rather than a prescriptive basis and, anyway, how can you gauge where people will have heart attacks?

SafetyAtWorkBlog is wary about relying on technology to solve problems simply because it seems simpler.  In the long-term, technology can be become cumbersome, unnecessarily expensive to maintain and often increasingly unreliable.  It is suggested that a cost/benefit exercise of the new defibrillators in Southern Cross Station would show them to be an unnecessary expense.  Direct cause and effect in terms of first aid is difficult to quantify.  But then again, according to the Premier’s media statement:

“In the 2007/08 financial year, Ambulance Victoria responded to 133 emergency cases at Southern Cross Station, including five cardiac arrest incidents.”

Defibrillators were obviously not applied as quickly in those incidents as can be in the future but for those first aiders in this blog’s readership the following statistic can be quite useful.

“Victoria has the best cardiac arrest survival rate in Australia, with 52 per cent of patients arriving alive at hospital.”

Let’s hope that these defibrillators will stop the Southern Cross Station from being a “terminal”.

Kevin Jones

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