• Tidak ada hasil yang ditemukan

Policy and Politics of Health Risk Management in Five Countries

N/A
N/A
Protected

Academic year: 2023

Membagikan "Policy and Politics of Health Risk Management in Five Countries"

Copied!
390
0
0

Teks penuh

University of Tokyo, Japan Professor Kazuhiko Takeuchi University of Tokyo, Japan Aim and scope of the series. The Alliance for Global Sustainability (AGS) is a unique, international partnership between four of the world's leading science and technology universities: the Swiss Federal Institute of Technology, Zurich, the Massachusetts Institute of Technology, the University of Tokyo and Chalmers University of Technology.

Conclusions

Introduction

Health Risks and Their Management

The Policies and Politics of Health Risk Management

The search for safety is a balancing act: how can we use risk to get more of the good and less of the bad (Wildavsky 1988). In some cases, government action is based on the law of sacrifice: the safety or macrostability of the whole is dependent on the riskiness (risk-taking) or instability of the parts.

Research Project: Strategic Management and Communication of Health Risks

As expected of a government, the first function of management is "foreseeing", a word that means on the one hand to predict and foresee, and on the other hand to ensure and make reliable (Foyol 1916). For example, the mere possibility of an increase in the risk of cancer, no matter how small or speculative, is sufficient to justify severe regulatory restrictions on the use of a suspect substance.

Concepts and Models as Perceptive Lenses

The activities of social groups and coalitions can influence every stage of the policy process. Public trust in government agencies and policies depends on the public's perception of the knowledge and expertise of the regulators, their openness and honesty, and their concern and care for the problem and the public (Peters et al. 1997).

Case Studies

In 1989, the WHO recommended a ban on the use of crocidolite and amosite, and many European countries followed suit in the 1990s. In the UK, small-scale industrial use of asbestos began in the late nineteenth century.

Table 1.1 Asbestos types and their characteristics
Table 1.1 Asbestos types and their characteristics

Comparative Study on Policy and Politics

Again, science policy and risk management must address both the context of application and the context of implication, both immediately and in the long term. While it is true that the government has learned from both cases to be much more open and accountable, the long-term effects require an acknowledgment of responsibility long after the major crises have passed.

Policy paradigms, social learning and the state: the case of economic policymaking in Britain. Science, policy changes, and the garbage can model: ending leprosy isolation policies in the US and Japan.

Management of environmental risk

Cases of asbestos

Exposure to some forms of asbestos in highly contaminated environments can lead to asbestosis, lung cancer and mesothelioma. The causal links of asbestos to these diseases became gradually evident in the early twentieth century (Navarro 2003; . Wikeley 1992).

Development of Asbestos Regulation in Japan

Asbestos' natural resistance to heat and acid, its tensile strength and its remarkable thermal, electrical and sound insulating properties (Sawyer 1977) have led to its use in over 3,000 applications, including floor and ceiling tiles, boiler and pipe insulation (sprayed). or plastered on), wallboard, roofing materials, brake linings and cement water pipes (Rome 1992). After the first decade, however, concerns about the impact of asbestos on human health arose as a result of the excessively high rate of disease discovered among workers who handled the material in mining, manufacturing and construction.

Incremental Policy Making and Crisis Politics

Although the dangers of asbestos are scientifically clear, countries have nevertheless adopted a range of public policies on the asbestos problem. Even in the 2000s, long after the health hazards of asbestos were scientifically established, differing policy positions led to an international trade dispute: Canada brought the French ban on asbestos products before a World Trade Organization (WTO) panel.

Materials and Methods

Asbestos-Related Health Hazards and Regulatory Policies in Japan

Based on the panel report, "Prevention of Hazards Due to Specified Chemical Substances (SCS) Ordinance of 1971 (SCS Ordinance of 1971, [Tokutei Kagaku-busshitsu tou Shougai Yobou Kisoku])". Each ministry was asked, whenever applicable, to review the occurrence of asbestos-related diseases in industries under its jurisdiction (eg the shipbuilding industry under the MLIT) and, at the same time, review its own policies for asbestos, evaluating how they had handled this issue so far.

Fig. 2.1 Asbestos import to Japan, lung cancer and mesothelioma
Fig. 2.1 Asbestos import to Japan, lung cancer and mesothelioma

Discussion

In the 1980s, the debate in the Diet mobilized various administrative agencies, eg, MHW and MEd, to act; in the 2000s, they led to the passage of the "Relief Act". At MHLW's insistence, lawmakers in the Diet supported a complete ban on asbestos, overcoming industry resistance.

Conclusions

Asbestos exposure and occupational background: Evidence from asbestos fiber and ferrous body concentrations in the lungs. Studies of asbestos contamination in the lungs of the populae: Trend of the incidence of febrile bodies during 45 years.

Emergence of Asbestos-related Health Issues and Development of Regulatory Policy in the UK

1924 to 1974): The Pre-risk Management Era of Asbestos Production and Regulation

Edward Merewether reported a statistical analysis in the Annual Report of the Chief Inspector of Factories for 1947. For the T&N, the impetus provided by the Asbestosis Scheme culminated in the establishment of the Asbestosis Fund in 1931 (Tweedale 2001, p. 70).

Table 3.1, taken from Bartrip (2004, pp. 74–75), lists the key medical events and  publications during this period of asbestos use
Table 3.1, taken from Bartrip (2004, pp. 74–75), lists the key medical events and publications during this period of asbestos use

1974 to 1999): Establishing an Institutional Risk Framework for Asbestos

This reform followed the establishment of the Government's Asbestos Advisory Committee in 1979 and European Community Directives in 1983 (all discussed in the next section). This institutional apparatus took the form of the Health and Safety Commission (HSC) and the Health and Safety Executive (HSE).

Table 3.3 Members of the Advisory Committee on Asbestos (ACA), the Simpson Committee The following membership represents the balanced set of ‘interests’ deemed appropriate after  the 1974 Health and Safety at Work Act (HSWA)
Table 3.3 Members of the Advisory Committee on Asbestos (ACA), the Simpson Committee The following membership represents the balanced set of ‘interests’ deemed appropriate after the 1974 Health and Safety at Work Act (HSWA)

1999 to 2007): The “Europeanization” of Asbestos Risk and the Current Management Framework for Asbestos Risk

A new player in this recent period of strategic management of asbestos in the UK has been the insurance industry. A review of Table 3.4 shows a clear shift in the priorities of the main UK risk management agency.

Fig. 3.3 Procedures for tackling uncertainty when assessing risks
Fig. 3.3 Procedures for tackling uncertainty when assessing risks

Final Observations

The origins and evolution of the asbestos limit value: scientific indifference and corporate influence. Thirty years on and looking ahead: the evolution and future of the health and safety system in Great Britain.

Development of Asbestos Regulation in France

Asbestos is probably one of the most feared pollutants on earth, and in practice it is the most expensive pollutant to regulate and remove. A question remains why the French government decided to ban asbestos around 1996.1 This choice not only reflects changes in the balance of power, public mobilization, media coverage of the crisis, epidemic outbreaks and the emergence of scientific evidence; it also reflects a change in decision rationality.

Policy Making Under Uncertainty and Precautionary Principle

Some analysts see uncertainty and the need for action as the essence of the precautionary principle. In the discussion section, several different typologies for policy decisions under uncertainty will be described and the rationales for decisions to regulate or ban asbestos in France will be considered.

The History of Asbestos in France

1900–1964): Quasi-Confidentiality

They say that there was an understanding of the effects of dust on this weak nature, and that the lungs of previously sick workers are attacked by the silica crystals leading to the onset of tuberculosis in workers prone to disease" (Teissonnière & . Topaloff 2002) ).If they are dead, the spouse is entitled to a limited life annuity (a certain percentage of the victim's annual wage).

1964–1974): Heavy Consumption of Asbestos and Evidence of Health Risks

1974–1977): The Coalition Between Workers and the University of Paris 6–7, and the Strategy of Controlled Use

It was later regarded as "the first asbestos scandal". Since 1974, university physics researchers have discovered the presence of an unknown dust during their regular experiments. Experts conducted four studies during this period, culminating in a report by Cherchar of the Center d'Etudes et de Recherches des Charbonnages de France (Research Center of the French Coal Board), which concluded that "..the amount found in the area Jussie must be considered unacceptable.”5 In 1976, trade unionists at the University of Paris joined the Amisol workers.

1977–1994): Years of Silence due to the Innovative Permanent Asbestos Committee (CPA)

He mentioned that the conclusions of his colleagues differed from those of the Livre Blanc de l'Amiante, which had been developed by the industry. On an international level, April 1993 witnessed the birth of the Ban Asbestos Network (BAN), a private international organization based in France, which took action against the use of asbestos and its dangers: it published the manifesto Le livre noir de l' amiante (The Black Book on Asbestos) (Ban Asbestos Network 1993).

1994–1996): Trials, the Collective Expertise of the INSERM, and a Decision to Ban Asbestos

In the same year, Jussieu's Amiante Comité complained about the article of the new penal code on "poisoning" and. The ban was set to go into effect just one week later, on January 1, 1997.8 The intent of the ordinance was to protect workers and consumers by prohibiting the manufacture, marketing, import, export, or withholding of shipment of any product containing any type of asbestos fibers.

1996–1998): Creation of the Public Health Agency for Prevention and Precaution

1998–2002): New Version of the Law Regarding Employers’ Inexcusable Fault

One of the most significant changes in the management of asbestos hazards during this period occurred in France on February 28, 2002, a historic date for victims of asbestos exposure. Before FIVA, there were car funds and funds for victims of HIV infection.

2002–2007): Double Standards and Substitutes for Asbestos

In 2000, Kourilsy and Viney reported to the Prime Minister on the interpretation of the precautionary principle. Morgan and Henrion add a final option, which is close to the elements of the precautionary principle.

Table 4.1 Decision criteria applicable to policy analysis for risk management 1. Utility-based criteria Deterministic benefit-cost
Table 4.1 Decision criteria applicable to policy analysis for risk management 1. Utility-based criteria Deterministic benefit-cost

Asbestos in the United States

Today, asbestos is found in hundreds of products, from brakes and insulation to building materials and household products (Bowker 2003). Although friable asbestos is now regulated, many products such as building or insulation materials are common in homes and workplaces today; their construction predated the asbestos policy.

Medical Evidence of Asbestos Harm in the US

During the 1980s, concern about asbestos resulted in the new industry of asbestos abatement (Wisconsin Department of Natural Resources. It is likely that thousands more asbestos-related health articles have been published in the past 70 years.

Opportunities for Asbestos Exposure in the US

It is surprising that an outright ban on asbestos products was not imposed in the US during the second half of the twentieth century at mines such as W.R.; As a result, many products containing asbestos are commonly found in homes today.

Impact of Asbestos: US Mortality Rates

The U.S. Consumer Product and Safety Commission (CPSC) provides consumer information about what types of products may contain asbestos and how people should respond if they discover asbestos in their home. Old small appliances that may contain asbestos and are still in circulation are not listed on CPSC's consumer information site.

The Regulatory Environment for Asbestos

The CAA “regulates air emissions from area, stationary, and mobile sources.”4 The CAA also authorized the EPA to create testable air quality standards that protect the environment and people in the interest of public health: the National Ambient Air Quality Standards (NAAQS). An analysis of 10K filings for these companies for the years 1998 to 2002 concluded that: “Chapter 11 companies have been able to continue operating successfully.

Industry Risk-Management Response to Public Concerns

The act would also have amended the Public Health Service Act to direct and promote research into asbestos and to serve as "a national clearinghouse for data and samples relating to asbestos-related diseases" (Congressional Research Service 2007). National Asbestos Awareness Week", which was passed unanimously in the Senate (the same resolution was passed the year before).

Self-Regulatory Actions

In 1979, manufacturers representing 90% of US household brands of electric hair dryers stopped using asbestos in their appliances. Questions have recently been raised by CPSC and the news media as to whether there is a health hazard posed by the presence of asbestos in handheld hair dryers.

Recent Major Asbestos-Related Incidents and Litigation The Libby, Montana Case

The change centered on the EPA's desire to ignore decades of what are considered solid studies documenting the true danger of the most common type of asbestos – chrysotile. Messages in the Dust' is a detailed analysis of the government's response to the aftermath of September 11 and the resulting cover-up.

International Focus

Canada appealed to the WTO in 1999 when France banned the import of asbestos due to public health concerns. In the end, however, the health and environmental consultants were able to influence the WTO's decision.

Asbestos-Related Actions Asbestos Profiteers

In the end, the WTO sided with France, finding that a member nation has the right to ban imports if it is necessary to protect public health. This was an unusual case, as Canada expected the WTO to support its claims under the banner of free trade.

Asbestos Education and Public Health Advocacy Media

One of the most powerful lobbying coalitions in Washington DC is the Asbestos Study Group (ASG). The coalition is powerful thanks to its financial support: “The Asbestos Study Group reported spending $5.56 million lobbying for legislation to end asbestos lawsuits in the first half of 2003, making the group, according to its disclosure forms is one of the largest lenders.

Preliminary Conclusion

Messages in the Dust: What Are the Lessons of the Environmental Health Response to the 9/11 Terrorist Attacks? Historically, the regulation of the production of asbestos products in one country has only led to the transfer of the production base to another country.

Risk Perception and Management

An association of asbestos with lung cancer and malignant mesothelioma has been reported since the second half of the twentieth century, and since then asbestos has become one of the most recognized occupational carcinogens. Lung cancer and malignant mesothelioma caused by exposure to asbestos will continue for many years to account for the majority of diagnosed and compensated occupational cancers in the world.

We then attempted to identify the key players in the rise and fall of asbestos consumption in Korea. Changes in consumption generally reflect changes in the demand and use of asbestos products by different industries.

Results

  • 1920–1959): Minimal Consumption of Asbestos
  • 1960–1982): Industrial Expansion
  • 1983–1995): The Plateau of Asbestos Consumption
  • 1996–Present): Shrinkage of Asbestos Industry

During the period of expansion in the asbestos market, none of the responsible parties paid any attention to asbestos health hazards. During this period, most of the coverage of asbestos handling problems was limited to foreign news reports.

Fig. 6.1 Asbestos consumption in Japan and Korea
Fig. 6.1 Asbestos consumption in Japan and Korea

Management of food risk

Cases of BSE-related human risk management

In retrospect, too many precautionary measures seem to have been nothing more than unscientific and unproductive hype, interpreted by the public as policy mistakes and government negligence. The BSE problem is further complicated by the fact that the management of BSE risks requires the cooperation of several sectors of society, including agriculture.

Policy and Politics of BSE-related Human Disease Prevention in Japan: In Pursuit

With the above as background, this article aims to examine from an international comparative perspective the history of the BSE problem and government responses (or lack thereof) to it, with an emphasis on communication efforts to reassure the public. The following two questions will be answered: (1) Has the BSE issue ultimately helped the public and policy makers to understand food risks and the management of these risks. 2) Have the communications efforts of governments or the media successfully served as public forums in promoting democratic values.

Chronology of BSE-Related Events and Policies in Japan BSE as a Cattle Disorder

The first meeting of the MAFF panel of experts on BSE was held on 5 October. On 22 December, the MAFF announced a ban on the import of beef products from EU countries, and the MHLW called for a voluntary stop on the import of products containing beef organs from the EU.

Gambar

Table 1.1 Asbestos types and their characteristics
Fig. 2.1 Asbestos import to Japan, lung cancer and mesothelioma
Table 3.1, taken from Bartrip (2004, pp. 74–75), lists the key medical events and  publications during this period of asbestos use
Fig. 3.1 Structure of the Asbestos Research Council (ARC) 1957–1968
+7

Referensi

Dokumen terkait

Schedule 2: Interpretation Act means the Hazardous Substances and New Organisms Act 1996 asbestos has the same meaning as in regulation 31 of the Health and Safety at Work Asbestos