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Sixth Edition
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| Figure 1.1. | Examples of various types of risk communication. |
| Figure 3.1. | Risk communication and public involvement activities associated with the Superfund cleanup process. |
| Figure 7.1. | Primary purpose of risk communication related to newness and visibility of the risk. |
| Figure 9.1. | Simplified expert model of the risk of infection from Lyme disease. |
| Figure 9.2. | Expert model of the risks associated with HIV and AIDS. |
| Figure 10.1. | Determining when to use stakeholder participation to communicate risk. |
| Figure 12.1. | Outline of a risk communication plan. |
| Figure 12.2. | Audience-centered technique for communication planning. |
| Figure 13.1. | Information to include in written risk communication messages. |
| Figure 14.1. | Illustration from a brochure on health risks of electric and magnetic fields. |
| Figure 14.2. | Redesigned map of groundwater contamination on a federal site in 1994. |
| Figure 14.3. | “Locator” state map used in conjunction with a more detailed map. |
| Figure 14.4. | Time line of dates and events. |
| Figure 14.5. | Chart used to help people determine their own radiation dose from various sources. |
| Figure 14.6. | Addiction self-test. |
| Figure 14.7. | Example “road map.” |
| Figure 14.8 | Range of possible radiation doses by category. |
| Figure 14.9. | Human figures used in risk estimates. |
| Figure 14.10. | Risk estimate in bar graph format. |
| Figure 14.11. | Graphical displays of heart disease risk with and without hormone replacement therapy (HRT). |
| Figure 14.12. | Added risk of side effects from medical treatment among 100 women. |
| Figure 14.13. | A typical “cone-of-uncertainty” graphic used for hurricane warnings. |
| Figure 14.14. | Additional graphic for hurricane warnings, showing probability by geographic area. |
| Figure 14.15. | Example of a cumulative distribution function. |
| Figure 14.16. | Examples of tobacco warning labels shown to be effective. |
| Figure 14.17. | Warning symbol for respiratory sensitization, cancer, and other human health hazards. |
| Figure 14.18. | Four versions of medication warning labels that were pretested with adolescents. |
| Figure 14.19. | Medication warning label with text added to increase understanding. |
| Figure 14.20. | Risk ladder for radon. |
| Figure 14.21. | Deceptive use of data. |
| Figure 14.22. | Relative versus absolute risks. |
| Figure 15.1. | A film crew recording the stories of people impacted by the volcanic eruption of Nevado del Ruiz, Colombia. |
| Figure 18.1. | Touch-screen program in a kiosk in Barrow, Alaska. |
| Figure 18.2. | Mass casualty response scene in OLIVE, software for creating virtual worlds. |
| Figure 18.3. | Virtual reality emergency room exercise. |
| Figure 18.4. | Stanford Medical Center, real (a) and virtual (b), for emergency response training. |
| Figure 22.1a. | Crowdsourcing with social media after a storm in the Philippines. |
| Figure 22.1b. | Crowdsourcing with social media. |
| Figure 22.2a. | Nepal crisis map. |
| Figure 22.2b. | Volunteers keeping calm and carrying on. |
| Figure 22.3. | Hurricane crisis map. |
| Table 4.1. | Example organizational roles in risk communication |
| Table 4.2. | Reasons the audience can be hostile |
| Table 5.1. | Advantages and disadvantages of involving the public in risk assessment, management, and communication |
| Table 5.2. | Stages when audience concerns and perceptions can be factored into the risk assessment or risk communication efforts |
| Table 5.3. | Matching spokespersons to audience characteristics |
| Table 6.1. | Acceptability of risk comparisons |
| Table 7.1. | Risk communication purposes based on job relationships |
| Table 8.1. | Key audience characteristics for the baseline audience analysis |
| Table 8.2. | Key audience characteristics for the midline audience analysis |
| Table 8.3. | Key audience characteristics for the comprehensive audience analysis |
| Table 8.4. | Less-direct sources most useful for audience analysis for various types of risk communication |
| Table 8.5. | Using audience analysis information to tailor risk messages |
| Table 9.1. | Sample message map. Stakeholder: General Public. Question: How contagious is smallpox? |
| Table 14.1. | Considerations for showing visuals in various media |
| Table 14.2. | Options for portraying various aspects of risk visually |
| Table 14.3. | Home radon risk for smokers and corresponding recommendations |
| Table 16.1. | Questions to ask before an interview |
| Table 17.1. | Advantages and disadvantages of stakeholder participation in risk communication |
| Table 17.2. | Effective stakeholder participation for care, consensus, and crisis risk communication |
| Table 18.1. | Communication objectives and corresponding technology-based applications |
| Table 19.1. | How social media can be used for various types of risk communication |
| Table 20.1. | Types, contributions, and expectations of potential partners |
| Table 21.1. | Evaluation factors to consider for care, consensus, and crisis communication |
| Table 21.2. | Advantages and disadvantages of using various evaluators |
| Table 22.1. | Characteristics of emergency risk communication |
| Table 22.2. | Typical staff roles in the emergency risk communication process |
| Table 22.3. | Examples of stakeholders and their concerns in an emergency |
| Table 22.4. | Communication actions in the first 48 hours of an emergency |
| Table 22.5. | Phased message dissemination for hurricanes and floods |
| Table 24.1. | Evaluation in public health campaigns |
The first edition of this book came about because Regina Lundgren had always been fascinated with communication. She started writing novels in the third grade. When she was asked on her first day at the University of Washington what she hoped to do with her degree in scientific and technical communication, she replied, “I want to write environmental impact statements.” When Patricia Clark hired her to work at the Pacific Northwest National Laboratory to do just that, she was overjoyed.
Her fascination with communication led her to pursue an interest in risk communication. That in turn took her from leading the public relations function for an 800-person environmental research and development organization to developing her own consulting and training firm. Since then, she has been on a panel for the first workshop on risk communication for weapons of mass destruction events; developed the risk communication plan for the most sophisticated cancer cluster investigation in the nation's history; crafted one of the first state-level risk communication plans for public health preparedness; and taught countless scientists, engineers, and communicators to share complex scientific and technical information among other projects for clients in government, industry, and academia.
Her earlier work at the Pacific Northwest National Laboratory put her in contact with Andrea McMakin, an accomplished risk communicator who had led environmental risk communication efforts that touched several states. Andrea's master's degree in communication, experience in training scientists and engineers to communicate, and firsthand knowledge of working with the news media as both writer and facilitator made her the perfect coauthor from the second edition of this book to this sixth edition.
The previous editions of this book have been used by practitioners, students, and teachers of risk communication across the United States and in at least 20 other countries. Readers' suggestions and new experiences have helped us make the new edition even more useful in terms of content. We added new content on understanding lessons learned from some of the major disasters in the last two decades, developing robust partnerships, and countering false information as well as the growing body of evidence on how the brain processes risk information. We updated and expanded information on social media, technology-based applications, and public health campaigns.
This book was not written in a vacuum. We owe much of our own knowledge to our forebears in risk communication, including Vince Covello, Peter Sandman, Billie Jo Hance, Caron Chess, Baruch Fischhoff, Paul Slovic, Roger Kasperson, and Jim Creighton. Several other experts in science, management, and communication have inspired us by personal example: Pete Mellinger, Emmett Moore, Jack Robinson, Lori Ramonas, Bob Gray, Judith Bradbury, Kristi Branch, Geoff Harvey, Bill Hanf, Marilyn Quadrel, Dan Strom, Darby Stapp, Barb Wise, Randal Todd, and Dr. Sandy Rock.
Regina would like to thank Laurel Grove, who brilliantly edited the first edition, and Kristin Manke, who provided a professional index for the book. Most of all, Regina would like to thank her husband Larry and sons Edward and William, who always support her in all she does.
Andrea wishes to acknowledge the advice and review of several experts, including L.A. Times reporter David Shaw; science journalists Karen Adams, Mary Beckman, and Bill Cannon; radio reporter Charles Compton; media specialists Geoff Harvey, Greg Koller, Melissa O'Neil Perdue, Staci West, and Franny White; social media specialists Denice Bruce and Jodi Hamm; Portland State University professor Char Word; statistician Greg Piepel; graphic artist Mike Perkins; and information technology specialist Don Clark. She also thanks the many communication and public health researchers and information specialists who answered questions and corrected errors.
Regina and Andrea gratefully acknowledge peer review of the second edition by two luminaries in the risk communication field: Caron Chess, Director of Rutgers University's Center for Environmental Communication, and Susan Santos, founder and principal of the health and environmental management and risk communication consultancy FOCUS GROUP. Their insights and suggestions helped us think through several issues while staying true to the experiences of our readers.
We also thank Steve Welch for having the vision to continue publishing the book, Mary Hatcher for requesting the fifth and sixth editions, the other staff at Wiley-IEEE Press for their help and encouragement, and the reviewers from the IEEE who provided suggestions to improve this edition, especially Sean Tolnay, Director of the Naval Civil Engineer Corps Officers School Environmental Training Division; Dr. Tim Sly, Ryerson University; and Dr. Donna Kain, East Carolina University.
We welcome comments and suggestions from readers; please send them to us in care of our publisher, Wiley-IEEE Press, at pressbooks@ieee.org.
Regina E. Lundgren
Andrea H. McMakin
Regina E. Lundgren is an independent consultant in risk communication, public involvement, and science and strategic communication. For more than 30 years, she has specialized in communicating environmental, safety, and health risks to lay audiences. Her communication materials have won national and international awards. She serves her clients in government and industry in a variety of roles, from consultant to trainer to project manager. She developed the risk communication plan for the most sophisticated cancer cluster investigation in the nation's history and consulted on the first state-level system to communicate flood disaster risks to the public. She conducted research on the mental models approach to risk communication. She is a frequent speaker and trainer to industry groups, professional societies, and government organizations. She has a degree in scientific and technical communication from the University of Washington and a certificate in regulatory analysis from the Harvard School of Public Health. You can learn more at her website at http://www.rlriskcom.com.
Andrea H. McMakin is a communication specialist at the Pacific Northwest National Laboratory, a U.S. Department of Energy national laboratory in Richland, Washington. For more than 30 years, she has been involved with risk communication programs in national and global security, climate change, health and environmental impacts, worker chemical exposure, and risk perception research. Her work has been published and cited in technical journals, scientific and trade publications, and major regional newspapers. She holds a Master of Arts degree in communication from Washington State University.
Risk communication encompasses many types of messages and processes. It is the poster warning food workers to handle food safely to prevent the spread of Escherichia coli bacteria. It is the emergency response worker rallying a community to evacuate in the middle of the rising flood. It is the community representatives sitting down with industry to discuss the siting and operation of a hazardous waste incinerator. Risk communication involves people in all walks of life—parents, children, legislative representatives, regulators, scientists, farmers, industrialists, factory workers, and writers. It is part of the science of risk assessment and the process of risk management.
This book was written for those who communicate health, safety, and environmental risks, primarily the following:
Because each of these readers may have different needs and questions concerning risk communication, we have divided the book into five parts. Each part or chapter within a part is relatively self-contained; a reader can choose to read some chapters and to skip others of less interest. Part I gives background information necessary to understand the basic theories and practices of risk communication and provides a basis for understanding information in the other parts. Part II tells how to plan a communication effort. Part III gives guidance on using various methods of communicating risk. Part IV discusses how to evaluate risk communication efforts, including how to measure success. Part V offers advice on special cases in risk communication: emergencies, public health campaigns, and international communication. A list of additional resources, a glossary, and an index are also provided. To emphasize key points, each chapter concludes with a summary section. Chapters that discuss how to apply risk communication (as opposed to those that deal with more theoretical aspects like principles and ethics) end with a checklist, which can be used to help plan and develop your risk communication efforts.
Much of our research and theory discussions, case studies, and recommendations draw from U.S. experiences, because that is our area of greatest familiarity. However, many of the risk communication principles we describe also apply to other countries. Readers will also find, sprinkled throughout the book, examples of country-specific risk communication research, successes, and pitfalls. Chapter 23, International Risk Communication, offers considerations for risk communicators outside of the United States and those who must address multi-country risks.
Many of the terms used in this book are defined in ways that differ slightly from usage in other branches of science or communication. A glossary is provided, but as a beginning, we want to explain exactly what we mean by risk communication and how it differs from other forms of technical communication.
Technical communication is the communication of scientific or technical information. Audiences can range from children in a sixth-grade science class, to workers learning a new procedure on a piece of equipment, to scientists reviewing the work of peers. The purpose of technical communication can be to inform, educate, or even occasionally persuade.
Risk communication is a subset of technical communication. As such, it has its own characteristics. At its most basic, it is the communication of some risk. (In this book, it is used to mean the communication of health, safety, or environmental risks.) The audience can be similar to those described for technical communication, but it can also be a wide cross section of the United States and beyond. For example, information to present the risk of not wearing seatbelts could have as an audience anyone who will ever ride in a car.
Sometimes, the risk being communicated is frightening to a particular segment of the audience. Other times, the audience is unaware of or even apathetic to the risk. In still other cases, the organization communicating the risk is not credible to a portion of the audience or the audience finds the way the risk is being managed to be unacceptable. The strong emotions, or the lack thereof, audiences associate with a risk can make it difficult to communicate.
The purpose of risk communication can also differ from that of technical communication. In dangerous situations, such as floods and tornadoes, risk communication may have to motivate its audience to action. In other situations, the purpose is more appropriately to inform or to encourage the building of consensus (more on this in Chapter 5). Another difference between risk communication and technical communication is that risk communication more often involves two-way communication, that is, the organization managing the risk and the audience carry on a dialogue. In technical communication, most efforts are designed to disseminate information, not to receive information back from the audience or to include the audience in the decision-making process. An example of two-way technical communication is scientists reviewing the work of peers.
Risk communication comes in many forms (see Figure 1.1). In this book, we generally divide risk communication along functional lines, distinguishing between care communication, consensus communication, and crisis communication, which are described in more detail later in this chapter. While these three forms have elements in common with other forms of technical communication, they always have circumstances that require different tactics, or ways of communicating, to effectively deliver their messages to and involve their respective audiences. For example, consensus communication involves much more audience interaction than do care or crisis communication. Risk communication can also be divided topically—for example, into environmental, safety, and health risk communication.
Figure 1.1 Examples of various types of risk communication.
Care communication is communication about risks for which the danger and the way to manage it have already been well determined through scientific research that is accepted by most of the audience. Another distinguisher is that, generally, those charged with communicating have little return on investment other than the betterment of human lives. Think of the American Heart Association and local public health agencies.
Two subsets of care communication are health care communication (sometimes called health education or health marketing), which seeks to inform and advise the audience about health risks such as smoking or AIDS, and industrial risk communication, which involves informing workers about potential safety and health risks in the workplace. Industrial risk communication can be further divided into ongoing communication about industrial hygiene and individual worker notification, which informs workers of the findings of retrospective mortality studies, in which the mortality rates of a set of workers have been evaluated against standards. Examples of these are the longitudinal studies to determine the effects of beryllium on energy workers (that is, whether they had a higher rate of mortality compared to standards).
Consensus communication is risk communication to inform and encourage groups to work together to reach a decision about how the risk will be managed (prevented or mitigated). An example would be a citizen advisory panel and the owner/operator of the local landfill working together to determine how best to dispose of hazardous chemicals found at the landfill. Consensus communication of risk is also a subset of stakeholder participation, which encourages all those with an interest (stake) in how the risk is managed to be involved in consensus building. Often, the agency or organization with the greatest financial stake funds this process. (Stakeholder participation is also generally called public engagement, public involvement, public participation, stakeholder involvement, public consultation, and audience interaction.) Stakeholder involvement, however, can go far beyond risk communication, into the realms of conflict resolution. These realms encompass entire disciplines in themselves and, hence, are beyond the scope of this book.
Crisis communication is risk communication in the face of extreme, sudden danger—an accident at an industrial plant, the impending break in an earthen dam, or the outbreak of a deadly disease. This type can include communication both during and after the emergency. (Communication during planning on how to deal with potential emergencies would be either care or consensus communication, depending on how much the audience is involved in the planning.)
An overview of the risk communication process will also help explain the concepts presented elsewhere in this book. The process begins with a hazard, a potential or actual danger to the environment or human health or safety. Examples include an oil spill (environment), cigarette smoking (health), and a loose stair tread in an office building (safety). Usually by law but sometimes by commitment, some organization is responsible for managing the risks posed by this hazard, that is, preventing or mitigating any damage (decreasing the probability or lessening the consequences). In the case of a land-based oil spill, the U.S. Environmental Protection Agency, among other organizations, must develop regulations to prevent occurrence and oversee cleanup if preventive measures fail. The American Lung Association has a commitment to eradicate cigarette smoking. The Occupational Safety and Health Administration requires that organizations maintain safe work environments.
Risk management usually begins with a risk assessment. Just how dangerous is the risk? How much of a hazardous chemical has to spill into a river before the water's natural self-cleansing ability is overwhelmed? Can AIDS be spread by contact with infected health care practitioners? How does the way workers use a forklift affect their risks of being injured or of injuring another? Risk assessment is a scientific process that characterizes risk and assesses the probability of occurrence and outcomes. Based on probabilities, it usually tries to answer questions such as the following:
Sometimes the risk assessment has a benefit component attached (risk/benefit analysis). This kind of analysis seeks to determine whether any benefits attached to the risk would balance against the harm caused. For example, does the benefit of the potential advancement of science balance against the potential harm of experimenting with radioactive materials? This kind of analysis may or may not include factors other than the strictly scientific evaluation of the risk and benefit.
Information from the risk assessment is used by risk managers to decide what to do about the risk. Their decisions, and often the process by which they decide, are usually communicated to the people who would be or are affected by the risk or to those interested in the risk for other reasons (ethical issues, for example). Sometimes the risk managers try to encourage this audience to take action (care or crisis communication), sometimes they need to educate the audience about the risk so that the audience has the information needed to make a decision (care communication), and sometimes they need to discuss the risk with the audience so that a consensus on a course of action can be reached with all parties speaking the same language (consensus communication).
In the case of consensus communication, the decision about how risks are to be managed is made through stakeholder involvement. This type of management requires risk communication that seeks to
For example, the process of using an environmental impact statement to evaluate a set of alternative actions often begins with a series of stakeholder meetings to encourage individuals and groups to help define what should be evaluated (this part of the process is called scoping). Care communication and crisis communication also need to identify stakeholder perceptions and concerns; however, in these cases, the information is used to develop messages that will inform the audience and will encourage them to take some course of action. An example of this is the U.S. Environmental Protection Agency's program to communicate the dangers of radon in the home (for example, Weinstein and Sandman 1993).
At any point during the process, the organization that has been communicating may evaluate its risk communication effort to determine successes and failures. What should be changed next time? What was most effective for this audience, in this situation? Is there anything that can be generalized to apply to other situations and audiences?
The ideas and techniques given in the rest of the book are tools. They are what we and other risk communicators have found to work for a given audience in a given situation with a given purpose. While a growing body of research lays out guidelines for effective risk communication, the differing dynamics among audiences, situations, and purposes makes finding the one “right solution” impossible, even if there is one right solution to find. Wherever possible, we have cited the work of others as confirmation of our own findings and those of other practitioners in the field. Citations for the research discussed in the text can be found at the end of each chapter. Other sources of information for risk communication can be found in the Resources section at the back of the book.
Many of the resources listed discuss such issues as credibility of the organization communicating or managing the risk, fairness of the risk in the audience's eyes, and trust among parties. These issues will be dealt with only as they relate to specific points in the rest of this book; however, they are important issues that heavily affect the ability to communicate risk effectively. Unfortunately, they are often outside the control of most of us who actually communicate risk. When we step in front of an audience, policies made by those far above us and sometimes years in the past have already either forged a bond of trust with the audience or broken it. Likewise, our credibility as risk communicators will depend on the credibility of other risk communicators who previously faced the same audience.
Although we cannot change the past, we can be aware of past mistakes or successes and make sure that our own efforts are trustworthy, credible, and fair, insofar as we have the authority to make them so. And we must champion the cause of trustworthy, credible, and fair risk management decisions in our own organizations, both because it is ethical and because it is the only way to ensure successful communication.
To understand risk communication, you will need to understand the approaches to communicating risk, the laws that shape the way we communicate risk today, the constraints to effective risk communication, the ethical issues, and the basic principles of risk communication, which have evolved out of the approaches, laws, constraints, and ethics. Additional sources of information are listed in Resources at the back of the book.