Risk communication in food-safety decision-making

CLAUDIA PROBART

Claudia Probart, Ph.D., is a Registered Dietitian, and is Associate Professor of Nutrition
and the Director of iTEL (Innovative Technology in Education Laboratory) at The Pennsylvania
State University, where she researches issues relating to technology in education and communication.
She is currently serving as Guest Technical Editor for Food, Nutrition and Agriculture for FAO.

Although new discoveries may potentially decrease poverty and hunger and improve health and well-being, these advances also present certain risks. When controversies arise regarding the relative benefits and risks of innovations, decision-making can become stalled and further progress towards addressing global problems may be limited. Society is faced with complex choices related to technology, medicine, the environment, agriculture and food. Food safety may be especially subject to controversy because of the unique role that food plays for both individuals and society, because food-related issues involve elements of economics and security, health and nutrition, and represent deeply held personal values. Risk communication, with its participatory approach, can potentially play a role in the process of making complex, value-laden food safety decisions that are supported by all stakeholders, including the consumer (Slovic, 2000; Sandman, 1987; Smith and Halliwell, 1999).

Sources of energy and recommendations for energy intakeEvolution of risk communication

Risk communication is an applied research discipline that began in the early 1970s as a unique field of investigation. It combines the theoretical framework of psychology, sociology, utility theory, decision science, education and communication. Risk communication began primarily with environmental hazards and has expanded into the study of other health-, economic- and social-risk issues. In the past, risk communication failures have sometimes resulted in the acceleration of mild public concern into protracted battles among consumers, regulators and industry. "Outrage" is the term used by risk communication experts to describe public reaction to what is considered to be an unacceptable hazard (Sandman, 1987); "stigma" is a term used to indicate a risk or controversy that has attracted a degree of horror and dread that spreads beyond a specific product or event to affect an entire industry (Slovic, 2000; Flynn, 2002). According to Sandman, when people have reached the stage of outrage or stigma, problem-solving and compromise become problematic, and decision-making is increasingly polarized and contentious. A growing body of research is accumulating to explain the complexity of risk perceptions and why such outrage and stigma are likely to occur in certain situations (Sandman, 1987). This research has shaped the evolution of risk communication.

Powell and Leiss (1997) have identified three phases of risk communication. The first risk communication efforts resulted from environmental accidents, such as oil and chemical spills, and concentrated mainly on providing information and education after the event had occurred. This phase could be called the education phase. The prevailing wisdom was that people were concerned about risks because they did not fully understand the scientific principles underlying issues such as radioactivity and chemical toxicity, and they were unfamiliar with the laws of probability. Had it been better educated, according to the proponents of this approach, the public would have been willing to accept the risks in accordance with expert opinions. However, this risk communication approach failed to decrease public controversy and discord over risk decisions made by regulators. Research began to show that the controversies that arose were not necessarily caused by public ignorance of them, but rather by people's perceptions, values and unwillingness to accept certain risks. While education is necessary, it is not sufficient to ensure that the public will tolerate risks perceived to be too high. A convincing body of research has been accumulating over the past three decades that demonstrates that the magnitude of dread felt by the public depends on perceptions of the risk characteristics of each particular hazard. Some hazards are less tolerable than others, and are often unrelated to statistical probability or actual morbidity or mortality. Risk characteristics that have been determined as important to the public in assigning risk to hazards are in general related to volition, control, fairness, familiarity and impact on future generations, among others (Sandman, 1992; Fischhoff et al., 2002).

As it became clear that risk communication strategies featuring information and education alone were not producing the desired effect, public-relations campaigns began to be initiated. This phase could be called a persuasion, or marketing, phase. The objective was to de-emphasize the issue of risk and instead promote corporate image by using advertising and marketing strategies and techniques. These efforts were somewhat successful, but nonetheless did not persuade the public to accept risks that were considered intolerable or unfair. Slovic and MacGregor (quoted in Powell and Leiss, 1997) point out: "Although attention to communication can prevent blunders that exacerbate conflict, there is little evidence that risk communication has made any significant contribution to reducing the gap between technical risk assessments and public perceptions or to facilitating decisions about major sources of risk conflict.... The limited effectiveness of risk communication efforts can be attributed to the lack of trust". An increasing loss of trust in regulatory institutions has been documented, polarizing positions and resulting in a spiralling loss of capability to gain public consent for regulatory decisions - as trust has been called the "coinage" of consensus-building (ibid.).

As risk communication has evolved, shaped from research based on analyses of successes and failures as well as study of public perceptions, three factors have consistently emerged as important determinants in avoiding controversy: ac-knowledging public perceptions, creating opportunities for early and meaningful participation, and gaining public trust. The two previous stages of risk communication were top-down and involved communication to - and not with - the public. And, as pointed out by Slovic and MacGregor (op. cit.), public trust is lost because of the closed decision-making process. The emerging risk communication phase incorporates lessons learned from the past and could be considered the participatory phase. This new risk communication strategy includes a movement towards shared stakeholder involvement and public participation in government and policy issues, including validation of public perceptions of risk. An example of a new paradigm in risk communication relating to food safety has been proposed by Canada (Chartier and Gabler, 2001). This greater participatory strategy, integrated throughout the risk analysis framework, could potentially facilitate public acceptance of regulatory decisions. However, it remains to be seen whether greater participation can really succeed in reducing controversy and facilitating decision-making in the complex arena of food safety.

Risk communication within the food-safety risk analysis structure

The risk analysis structure that is accepted internationally as the model for setting food safety standards consists of three components: risk assessment, risk management and risk communication (FAO, 1997). Each component is separate, with unique functions and responsibilities, but, as shown in Figure 1, the three components also overlap and share common areas. The FAO/WHO Expert Consul tation on Risk Management and Food Safety emphasized that it was important to separate risk assessment from risk management to ensure both that the assessment process would be independent and free from undue pressure, and that decisions would be based on science rather than myth or political factors (FAO, 1997). However, it was also emphasized that the process should be open and transparent, indicating a role for effective risk communication. Although it has been determined that risk communication is a factor in the risk analysis process, the entry point for involvement and the level of participation by the major stakeholders in the communication process remain controversial. New paradigms of risk communication involving early entry of participatory strategies seem particularly applicable today in a context of movement towards democratization and public consent (Slovic, 2000). Recognizing the importance of incorporating this opportunity for public participation into the food safety regulatory decision-making process, the Canadian Food Inspection Agency stated in one of its reports: "Engaging citizens is not merely a fashionable concept for public policy-makers: participatory democratic values have emerged and shaped the way risk communication is done" (Chartier and Gabler, 2001).

FIGURE 1

Structure of risk analysis

Participatory decision-making within the food-safety risk analysis structure is being explored at the national, regional and international levels. The Government of Canada has adapted a new framework for decision-making related to food and other hazards, based on work from the Government's Assistant Deputy Minister (ADM) Working Group on Risk Management. This model highlights the role of communication within each phase of the risk analysis process and is presented as Figure 2. The Canadian working group stated: "Stakeholder involvement is the key to building both acceptance and understanding of government policy decisions" (ibid.). According to Canadian officials, this participatory model of risk communication could potentially facilitate the democratic process and foster confidence and agreement on the decisions that are made (Smith and Halliwell, 1999).

FIGURE 2

Risk management in public policy: a decision-making process

Regional-level discussions are also being conducted to consider the importance of meaningful participation in the risk analysis process related to food safety. At the Pan-European Conference on Food Safety and Quality conducted in 2002, two papers were presented on the topic (FAO/WHO, 2002a, 2002b). Murray, representing the European Consumers' Organization, re-emphasized the importance of trust in decision-making and presented the results of a study comparing how the public ranked various governmental and organizational entities related to trust. Consumer organizations were given high ratings on measures of trust, suggesting a legitimate role for these groups as spokespersons within the risk analysis decision-making process. Murray went on to list steps for improving consumer confidence in the safety and quality of the food supply. These steps include full representation throughout the risk analysis process, inclusion of "other legitimate factors" of concern to the public when policy decisions are made, and interaction and communication among scientists, risk managers and consumers, as well as full transparency in the decision-making process (FAO/WHO, 2002a).

Sutton, representing Consumers International's, Office for Developed and Transition Economies at the 2002 Pan-European Conference, also called for greater participation by consumers, quoting the United States National Research Council: «Government should obtain the consent of the governed: citizens [...] have a right to participate meaningfully in public decision-making and to be informed about the bases for government decisions» (FAO/WHO, 2002b). Sutton's report continues with examples of nations that have integrated a consumer perspective into the risk analysis process. For example, the Ministry of Agriculture of Norway funds the Norwegian Consumer Council to participate in Codex task forces. This funding has provided the opportunity for consumer representatives in Norway to furnish input and gain international experience that is subsequently used to participate in national policy discussions (FAO/WHO, 2002b). According to Sutton, such additional funding is necessary to ensure equal participation in food safety debates.

To address the issues of effective risk communication and decision-making to protect the food supply at the inter-national level, three expert consultations were conducted by FAO/WHO on the process of risk analysis and food safety, which resulted in publication of guidelines for the risk analysis process (WHO, 1995; FAO, 1997, 1999). The first consul-tation, "Application of risk analysis to food standards issues", established the foun-dations of risk analysis applied to food standards. Definitions were agreed, and the importance of separating risk assessment from risk management to avoid undue pressure from special interests was emphasized (WHO, 1995). The subsequent two consultations interjected the importance of open participation and transparency throughout the risk analysis and decision-making process. The third consultation (1998), entitled "The application of risk communication to food standards and safety matters", reviewed the recommendations and conclusions of the previous consultations and addressed the role of risk communication within the risk analysis structure. Box 1 lists the considerations that were proposed for risk communication relating to new food technologies and chronic, low-level food-related risks. The considerations have been grouped in a sequence following a systematic risk communication approach. Similar considerations are listed in the report relating to emergency food-safety communication (FAO/WHO, 1999). Because risk communications typically focus on the scientific aspects of the risk, the consultation emphasized the importance of considering public concerns in the risk communication interaction. Unless public concerns become a component of the dialogue regarding the hazard under consideration, effective communication may be blocked. Box 2 lists nu-merous points to be considered for understanding and addressing public concerns. The consultation ended with specific guidelines for integrating communication into the risk analysis process (op. cit.).

The consultation provided recommendations for international organizations and for national governments on bilateral and multilateral bases. International considerations included continuing efforts to refine concepts and understanding of food-safety risk analysis, especially in the area of risk communication, as well as strengthening infrastructure for internal and external risk communication. Recommendations at the national level included establishing Food Safety Councils comprised of scientists, physicians, public health and food control experts, as well as representatives of consumer organizations and industry. These councils should provide input for national delegations to international food standards meetings; the deliberations and decisions should be made available to the public. Other recommendations targeted the training of risk communicators, the integration of food safety into primary health care for the public and the use of labelling as a risk management and risk communication strategy.

BOX 1

General considerations for effective risk communication

BACKGROUND/INFORMATION

Understand the scientific basis for the risk and attendant uncertainties.
Understand the public perception of the risk through such means as risk surveys, interviews and focus groups.
Find out what type of risk information people want.
Be sensitive to related issues that may be more important to people than the risk itself.
Expect different people to perceive the risk differently.

PREPARATION/ASSEMBLY

Avoid comparisons between familiar risks and new risks, as this attitude may seem flippant and insincere unless presented properly.
Recognize and respond to the emotional aspects of risk perceptions. Speak with sympathy and never use logic alone to convince an audience that may be emotionally affected.
Express risk in several different ways, making sure not to evade the risk question.
Explain the uncertainty factors used in risk assessment and standard setting.
Maintain openness, flexibility and recognition of public responsibilities in all communication activities.
Build awareness of possible benefits that may be associated with a risk.

DISSEMINATION/DISTRIBUTION

Accept and involve the public as a legitimate partner by describing risk/benefit information and control measures in an understandable way.
Share the public's concern; do not dismiss it as illegitimate or unimportant. Be prepared to give as much emphasis to these concerns as to the risk statistics themselves.
Be honest, frank and open in discussing all issues.
If explaining statistics derived from risk assessment, explain the risk assessment process before presenting the numbers.
Coordinate and collaborate with other credible sources.
Meet media demands.

REVIEW/EVALUATION

Evaluate the effectiveness of risk messages and communication channels.
Emphasize action to monitor, manage and reduce risk.
Plan carefully andUevaluate efforts.

SOURCE: FAO, 1999

BOX 2

Points to consider regarding public concern

RISKS TO WHICH ONE OR MORE OF THE FOLLOWING ASPECTS APPLY TEND TO RAISE PUBLIC CONCERN

The risk is an unknown, unfamiliar or rare event, as opposed to well-known or common hazards.
RIsks are controlled by others, rather than the public or the individual.
The risks result from industry actions or from new technology, rather than from natural causes.
The risks imply significant scientific uncertainty, or there is open controversy among experts as to the probability and severity of the hazard.
The risks raise moral or ethical questions, such as the fairness of the distribution or risks and benefits, or the rights or one group in society to put others at risk.
The decision-making process by which a risk is assessed is seen as being unresponsive or is unknown.

THEREFORE, IN ORDER TO MITIGATE PUBLIC CONCERN ABOUT RISKS, THE FOLLOWING STRATEGIES MAY BE USED

Make risks voluntary by giving choices to consumers whenever possible.
Acknowledge uncertainty.
Show that expert disagreement on an issue merely expresses uncertainty; estimating risks implies a range including estimates from at least two sides of a debate.
Determine the locus of control and aim to share it with interested parties.
Treat all interested parties with courtesy.
Take concerns seriously and listen to complaints.

SOURCE: FAO, 1999.

Conclusions

While this new paradigm for participa-tory risk analysis could decrease controversy and facilitate progress, some barriers nevertheless exist that must be overcome if participation and consensus on decisions related to the safety of the food supply are to be encouraged. The barriers include the lack of application of effective participatory risk communication strategies within existing decision-making processes, which in turn weakens public trust. Experts in risk communication see the lack of public trust in the regulatory agencies and the decision-making process as a major barrier against citizen acceptance of food safety and other regulatory decisions. Governments and regulators must not only work to gain public trust; they must act in a trustworthy manner so as to deserve and retain that trust. An important step in this process would be to implement an open and transparent risk analysis process as part of the new risk communication paradigm. However, many national and international regulatory bodies lack professionally trained risk communicators with the knowledge and skills to integrate participation in food-safety risk communication. Risk communication typically falls into the domain of media or public-relations departments in these organizations, and is practised by people who are well trained in advertising and news reporting but not necessarily in the concepts of the meaningful participation required for effective, two-way risk communication. In other cases, although trained risk communicators may function in the organization, they are not involved in the decision-making process until after critical issues have been decided, and are utilized only to suggest how to persuade consumers to accept proposed regulations.

The issue of adequate and equivalent funding for full stakeholder participation raises an additional barrier against effective participation when establishing food-safety regulations. At the national level, participation in the regulatory decision-making process is assured for well-financed interest groups that have the funding both for lobbying the political system and for sending spokespersons and scientists to participate in meetings related to food safety. However, consumer groups may lack sufficient funds to make the consumer position heard throughout the sometimes lengthy process. The same barriers exist at the international level. Sutton (FAO/WHO, 2002b) describes global surveys that show economically based differences in representation on global food standard discussions. Developing and transition countries, as well as consumer groups, cannot always match the funding levels of better financed stakeholders and are thus potentially at a disadvantage in terms of representation within the system. If funding issues are not addressed, the process of opening up the system to facilitate greater stakeholder participation might in fact en-courage a so-called "influence gap", and certain stakeholders would simply be unable to attend any discussion related to setting food safety standards.

Although significant barriers remain - and they cannot be ignored - research nevertheless points to increasing public participation within a new risk communication paradigm capable of engendering public trust, decreasing controversy and facilitating decision-making about potential food-related hazards. Additional research must be conducted to determine the best method to ensure the fair and meaningful partici pation in food safety hazard decisions by citizens of all nations. Slovic articulates these concepts by calling for "... a new approach - one that focuses on introducing more public participation within both risk assessment and risk decision-making in order to make the decision process more democratic, improve the relevance and quality of technical analysis and increase the legitimacy and public acceptance of the resulting decisions" (Slovic, 2000).

References

Chartier, J. & Gabler, S. 2001. Risk communication and government: theory and application for the Canadian Food Inspection Agency. Chapter 2: Theoretical aspects of risk communication. Available at http://www.inspection.gc.ca/englishcorpaffr/publications/ riscomm/ricomm/ ch2e.shtml. Accessed end of 2002.

FAO. 1997. Risk management and food safety. Report of a Joint FAO/WHO Consultation. FAO Food and Nutrition Paper No. 65. Rome. 27 pp. Available at http://www.fao.org/docrep/W4982E/W4982E00.htm. Accessed end of 2002.

FAO. 1999. The application of risk communication to food standards and safety matters. Report of a Joint FAO/WHO Expert Consultation. FAO Food and Nutrition Paper No. 70. Rome. 46 pp.

FAO/WHO. 2002a. Consumer information and participation in interactive communication with consumers on food safety, risks and food quality, by J. Murray. Pan-European Conference on Food Safety and Quality, Budapest, Hungary. Conference paper PEC01/11. Available at http://www.foodsafetyforum.org/paneuropean/documents_en.htm. Accessed end of 2002.

FAO/WHO. 2002b. Consumer activities related to food safety and quality in Central and Eastern Europe, by Consumers International. FAO/WHO Pan-European Conference on Food Safety and Quality, Budapest, Hungary. Conference room document PEC/CRD 12. Available at http://www.foodsafetyforum.org/paneuropean /index_en.htm. Accessed end of 2002.

Fischhoff, B., Slovic, P., Lichtenstein, S. & Combs, B. How safe is safe enough? A psychometric study of attitudes toward technological risks and benefits. In P. Slovic, ed., The perception of risk. London, Earthscan Publications. 474 pp.

Flynn, J. 2002. Nuclear stigma: notes on the social history of radiation. Report to the U.S. Department of Energy Low Dose Radiation Research Program. Available at http://www.decisionresearch.org/Projects/Low_Dose/research_reports.html. Accessed end of 2002.

Powell, D. & Leiss, W. 1997. Mad cows and mother's milk: the perils of poor risk communication. Montreal, Canada, McGill-Queen's University Press. 320 pp.

Sandman, P. 1987. Risk communication: facing public outrage. EPA Journal. Nov., pp. 21-22. Available at http://www.psandman.com/articles/facing.htm. Accessed end of 2002.

Sandman, P. 1992. Outrage and technical detail: The impact of agency behaviour on community risk perception. Research Project Summary, N[ew] J[ersey] Department of Environmental Protection and Energy, Trenton, NJ. Available at http://www.psandman.com/articles/ outrage.pdf. Accessed end of 2002.

Slovic, P. 2000. Trust, emotion, sex, politics and science: surveying the risk-assessment battlefield. In P. Slovic, ed., The perception of risk. London, Earthscan Publications. 474 pp.

Smith,W. & Halliwell, J. 1999. Principles and practices for using scientific advice in government decision making; international best practices. Ottawa, Canada, Report to the S & T Strategy Directorate, Industry Canada. Available at http://csta-cest.gc.ca/pdf/bestprac1_e.pdf. Accessed end of 2002.

WHO. 1995. Application of risk analysis to food standards issues. Report of the Joint FAO/WHO Expert Consultation. WHO/FNU/FOS/95.3. Geneva.

summary résumé resumen

Risk communication in food-safety decision-making	FOOD SAFETY ISSUES may be particularly subject to controversy because of the unique role that food plays for individuals and in society. Among the barriers to public acceptance of food safety decisions are lack of public trust in regulatory agencies, ineffective and outdated methods of risk communication, and unequal access and funding for participation of all stakeholders in the debate leading to regulatory decisions. Applying participatory risk-communication strategies in the decision-making process of food safety risk analysis has been suggested as one way to decrease controversy and facilitate openness and transparency. A new paradigm has evolved that includes two-way communication throughout the risk analysis process. Specific guidelines have been elaborated in a series of three expert consultations on risk analysis and risk communications related to food safety, conducted by FAO and WHO, and are included in the article.

Communication des risques dans la prise de décisions en matière de sécurité sanitaire des aliments	LA SÉCURITÉ SANITAIRE DES ALIMENTS est une question hautement controversée, étant donné le rôle unique de l'alimentation pour les individus et la société. Parmi les obstacles à l'approbation par le public des décisions prises en matière de sécurité sanitaire des aliments, on peut citer le manque de confiance de la population à l'égard des organismes de réglementation, les méthodes de communication des risques inefficaces et dépassées, ainsi que l'inégalité des conditions d'accès et de financement, qui nuisent à la participation de toutes les parties prenantes au débat menant à des décisions en matière de réglementation. Il a été proposé d'appliquer des stratégies de communication participative des risques à la prise de décisions sur les risques de sécurité sanitaire des aliments afin d'apaiser la controverse et de faciliter l'ouverture et la transparence. Un nouveau paradigme, prévoyant une communication dans les deux sens dans le processus d'analyse des risques, a fait son apparition. Trois consultations d'experts de l'analyse et de la communication des risques en matière de sécurité sanitaire des aliments, organisées sous l'égide de la FAO et de l'OMS, ont permis d'élaborer des directives spécifiques, lesquelles sont incluses dans cet article.

Comunicación de riesgos en el proceso de adopción de decisiones relativas a la inocuidad de los alimentos	LAS CUESTIONES RELATIVAS A LA INOCUIDAD DE LOS ALIMENTOS pueden ser objeto de especial controversia debido a la función singular que los alimentos desempeñan para las personas y la sociedad. Entre los obstáculos para la aceptación pública de las decisiones relativas a la inocuidad de los alimentos se cuentan la falta de confianza del público en los organismos reguladores, métodos ineficaces y desfasados de comunicación de riesgos, y un acceso y una financiación desiguales para la participación de todas las partes interesadas en el debate que da lugar a la adopción de decisiones normativas. Se ha propuesto la aplicación de estrategias participativas de comunicación de riesgos en el proceso de adopción de decisiones relativas al análisis de los riesgos para la inocuidad de los alimentos como medio para atenuar la controversia y facilitar la apertura y la transparencia. Se ha desarrollado un nuevo paradigma que comprende la comunicación bidireccional en todo el proceso de análisis de riesgos. En una serie de tres consultas de expertos sobre análisis y comunicación de riesgos para la inocuidad de los alimentos, que llevaron a cabo la FAO y la OMS, se establecieron orientaciones específicas, que se incluyen en este artículo.