Practical Opportunities to Improve the Impact of Health Risk Assessment on Environmental and Public Health Decisions

Following alerts about the diminishing role of health risk assessment (HRA) in informing

public health decisions, this study examines specific HRA topics with the aim of identifying possible

solutions for addressing this compelling situation. The study administered a survey among different

groups of stakeholders involved in HRA or decision-making, or both. The responses show various

understandings of HRA in the decision-making context—including confusion with the health impact

assessment (HIA)—and confirm recurring foundational issues within the risk analysis field that contribute

to the growth of inconsistency in the HRA praxis. This inconsistency lowers the effectiveness

of HRA to perform its primary purpose of informing public health decisions. Opportunities for

improving this situation come at the beginning of the assessment process, where greater attention

should be given to defining the assessment and decision-making contexts. Both must reflect the

concerns and expectations of the stakeholders regarding the needs and purpose of an HRA on one

side, and the methodological and procedural topics relevant for the decision case at hand on the

other. The HRA process should end with a decision follow-up step with targeted auditing and the

participation of stakeholders to measure its success.