Middlesex University, School of Health, Biological and
Environmental Sciences, London N19 5ND, UK
Introduction An all too familiar attribute of injury prevention activities, and safety issues in general, is their ability to generate public controversy. The fact that disputes are common whenever questions of safety (or risk) are raised is frequently attributed by professionals to ignorance and failures of rationality on the part of the wider public, or, failing that, to the ways in which the media handle safety issues. Although many authors have contested this simple proposition and indeed there is evidence that public concerns are not nearly as wayward as some suggest,1-4 the view nonetheless remains deeply entrenched. That this is so is evidenced by the continuing popularity, in some academic circles, of research programmes on the public understanding of science and perception of risk.
However, there is at least one other plausible explanation of the disputatious nature of safety which, although largely ignored, warrants consideration. This is the question of to the extent to which the numerous professional agencies involved, which range from international agencies to government departments, regulators, insurers, trade organisations, standards-setting bodies, academic institutions, consumer rights groups, solicitors and the courts, themselves have either a consistent or a rational approach to safety, and, in turn, how this impacts upon the public psyche.
Thus, the intention of this paper is to shift the spotlight away from the public’s alleged fallibilities and instead to consider professional and associated cultural perspectives on safety which are encountered in the field of risk and safety. The hypothesis is that there is far more to safety controversies than simple public misunderstanding of science or misperception of risk, and that a significant part of the problem lies in fact in a continuing failure by professions to expose the assumptions and choices peculiar to their own traditional decision making processes to proper debate.
Safety as viewed by the professions It should first be acknowledged that whenever hazards become a focus of attention, professional bodies face many dilemmas because of pressure to respond quickly. Frequently-adopted strategies in this case include going along with either someone else’s forcefully stated position, or the majority position, or adopting a strategy which is believed will deter any suggestion of indifference or incompetence. For those agencies who are actually managing hazards, another common response is to take actions which will deter claims of negligence. Unfortunately, none of these is guaranteed to be the most favourable option so far as injury prevention or risk management is concerned, let alone the wider public interest of which safety is but one priority. Agencies which adopt a more forceful position and attract others to their cause are not necessarily right. Indeed, it may be the case that followers do not understand what motivates a self-appointed lead agency to adopt a particular position, and if they did they might find it to be inconsistent with their own requirements.
In other circumstances agencies may go their different ways, adopting their own strategies, based on particular professional beliefs and ways of working. This could occur in situations where communication between agencies has historically been decoupled. The effective outcome may be to cocoon particular ways of working such that each develops along paths of its own without heed of others. Thus, specialisation becomes a double-edged sword in that while it may foster a high degree of expertise, that expertise can all too easily become out of kilter with what goes on elsewhere or what is preferable, leading to a fragmented and even corrupted system. Ultimately this can lead to entrenchment and alienation, and a diminution of what might have been achieved had a more open system existed in which each would have had the time and opportunity to learn from the experiences of others and to agree strategic principles.
It is often the case that vested interests are impugned in controversies over the management of risk, including human safety. As rightly implied by Sapolsky,5 one of the drivers of vested interest is material gain. However, as he also remarks, this is far from all. Many other factors may contribute, including status, professional cultures, homespun ideologies, and so on, all of which influence the positions adopted by individual agencies and the measures to which they subscribe.
One has only to listen to the continuing debate on safety as portrayed in the media, or to attend a major conference on injury prevention, to realise that there are many different concepts of what constitutes safety and good risk management, even amongst professionals. Rifts are by no means solely associated with the professional-public interface. Sometimes differences are attributable to disagreements over technical matters such as data interpretation. However, there is frequently present a deeper level of discord which, being hardly discussed, is more serious. This is to do with the concept of safety itself. In fact, it is clear that safety means different things to different people, and this in turn reflects itself in their ultimate priorities.6 The point is summarised by Table 1 which outlines the principles and characteristics of eight approaches to safety, all of which may be observed in operation in contemporary society in one place or another.
Spectre of litigation As one example, the problem of contrasting professional understandings of what constitutes safety is amply demonstrated by court procedures which, for some players at least, generate a lose-lose syndrome. When accidents occur and litigation is entered into, there is a strong tendency for lower courts, and the experts who act on behalf of injured parties, to rely solely upon comparison of accident circumstances with whatever written standards or advice can be found as a measure of culpability (i.e. as in column 3 of Table 1). The paradox is that standards and advice in many cases are not based upon risk assessment or considerations of practicability (as in column 8), which are supposed to be the current mainstay of UK safety regulation. In fact, standards have largely been the domain of ‘industry and trade, and with (only) a modest input from consumer representatives.’7 There is, furthermore, a feeling in some quarters that industry-based standards may be more or less strict depending on a host of factors more connected with commercial interests than consumer safety. So, while an agency responsible for managing a number of hazards may have done everything that was reasonable in the way of identifying hazards, measuring risks, and adopting practicable solutions, all fully in accord with the higher level definitions of safety and even case law, it may still fall foul of procedures which assign highly literal interpretations to advisory documents and this may well be judged a sufficient test of negligence by a lower court.
The disturbing feature of this is that authorities with strategic responsibilities are deterred from exercising that responsibility by a powerful culture which is used to relying almost exclusively on judgement (though they may be unaware of it) and hardly if at all on scientific evaluation. Instead, responsible authorities are encouraged to adopt what may be purely value-based recommendations that constitute no more than talismans for warding off potential litigation. Yet, while science and risk assessment certainly do not have all the answers, most would probably agree it is churlish if not irresponsible to disregard them in their entirety. The danger must exist that failure to critically assess the effectiveness of proposed safety measures, before and after implementation, by whatever means are available, increases the risk of more harm rather than less, and constitutes a potential waste of public and private money, not to mention the large volume of research now being undertaken in the field of injury prevention.
Concluding Remarks Different groups concerned with safety, sometimes formed along professional lines, tend to adhere to their own perspectives, passing others like ships in the night. It requires little imagination to contemplate the kind of effect which such a diversity of decision criteria and decision processes may have upon the public as recipient, particularly given the propensity of the media for sniffing out and highlighting inconsistencies. However, it would be incorrect to lay the blame for this at the door of either the media or the public. The problem lies with the inadequate attention paid to crucial and underlying philosophical issues about how far we want to go in implementing safety measures, what we are prepared to sacrifice in achieving certain goals, and how we should choose. In many cases these issues are mysteriously not addressed at all and may even be deliberately avoided. The consequence is that the system contains a substantial element of chaos, for one can never quite be sure which set of rules or procedures will dominate in the end in any particular situation. Neither is it only the public who are affected. The net effect upon duty holders – those with responsibilities for safety – can also be nigh on disastrous.
References
- Irwin A. and Wynne B. Misunderstanding science? The public reconstruction of science and technology. Cambridge: Cambridge University Press, 1996.
- Slovic P. Perception of risk: reflections on the psychometric paradigm. In: Krimsky S. and Golding D. editors. Social theories of risk. Westport, Connecticut and London: Praeger: 1992: 117-152.
- Schwarz M. and Thompson M. Divided we stand – redefining politics, technology and social choice. Hemel Hempstead UK: Harvester Wheatsheaf publisher: 1990.
- Houghton J. R., Murray E. and Ball D. J. Risk ranking by the British public: a survey of worry about a broad spectrum of risk issues. Human and Ecological Research 1999; 5 (3): 509-526.
- Sapolsky H. M. The politics of risk. Daedalus 1990;119 (4): 83-96.
- Ball D. J. Ships in the night and the quest for safety, Injury Control and Safety Promotion, 2000; 7 (2): 83-96.
- Rogmans W. Europe signposts a safer world; the way ahead for consumer safety in Europe. International Journal for Consumer and Product Safety 1997; 4, (4): 215-221.
| Safety criterion | Zero risk | Safety targets | Standards, CoPsc
and guidance |
Absolute risk | Risk factors | Risk assessment | Cost-benefit analysis
|
Risk tolerability and ALARPd |
| Typical adherents | Pressure groups | National and international agencies. Major industries | Traditional industries, lower courts, accident investigators | Actuaries and natural scientists | Epidemiologists and health scientists | Safety engineers and applied scientists | Economists | Higher courts, regulatory bodies, international agencies and major industries
|
| Basis of approach | Commitment | Political desire | Expert judgement | Historical data | Evidence | Scientific simulation
|
Utility theory | Case law (in the UK) |
| Strengths | Simplicity, single-mindedness | Clarity of overall policy goal | Should reflect a broad swathe of expert opinion. Tested over time | Enables insurance companies to set premia
|
Scientific basis | Analytical tool. Ability to forecast the unknown | Considers both costs and benefits of safety measures | Considers wider implications of safety measures including cost, practicality and other consequences
|
| Limitations | Associated benefits foregone. Cost of control disregarded | Top down approach which may be inconsistent with the sum total of individual safety interventions | Validity and motivation of judgements unclear. A bottom up approach which may be inconsistent with policy goals | Other social priorities are disregarded | Uncertainties, causality, and the question of ‘how safe is safe enough?’ | Uncertainties in assumptions, probabilities and dose-response functions | Anchored in a particular philosophy. Hidden assumptions and methodological problems, particularly in valuing benefits
|
Difficulty of striking a balance between competing attributes of a decision |
| Examples | ‘Vision Zero’, hand gun control, machinery guards, food additives | Injury targets. Air quality guidelines. Sustainability | Product safety standards. Workplace CoPs. Numerous personal injury court cases | Simple comparison of risks from different activities | Public exposure to radon and air pollution, playground safety | Occupational safety assessment | Railway and offshore safety investment decisions and major hazard control | Major hazard control, strategic planning applications |
Table 1: Eight different concepts of ‘safety’ with an indication of their origins and predominant professional affiliations. An attempt has been made to present these as a spectrum, with more politically-inspired or value-driven approaches on the left, with more science-based approaches in the centre, and with more pragmatic hybrids to the right. These divisions are not, however, clear-cut.6
cCodes of Practice; dAs Low As Reasonably Practicable
Note. A version of this article appeared under the title “Ships in the night and the quest for safety” in the journal Injury Control and Safety Promotion, 2000; 7 (2), pp 83-96, published by Swets and Zeitlinger 2000.
D.Ball@mdx.ac.uk