Implementing a Public Health Approach to Risk Management: Case Studies in Maine. Norman Anderson, American Lung Association of Maine, 128 Sewall St., Augusta, ME 04333
The risk management framework developed recently by the Commission on Risk Assessment and Risk Management emphasized two critical concepts: meaningful involvement of stakeholders in risk management decision-making and the need to place environmental health problems in a public health context. This presentation focuses on two examples in Maine that are illustrative of these concepts. Both involve projects initiated by the American Lung Association of Maine. The first focuses on a public protest over a medical waste incinerator at a small Maine hospital. Protesters demanded that the incinerator be shut down because of the health threat associated with its dioxin emissions. This protest occurred in the absence of any previous dialogue among the protesters, the hospital, the regulatory agencies, or the public health community regarding the nature of this potential threat and the ways that this problem could be effectively resolved. The Lung Association volunteered to intervene on this matter, employing a mechanism described in the Commission’s Risk Management Framework. The results of that intervention will be discussed. The second example focuses on the need to develop an effective surveillance system for asthma and other lung diseases as a means to define the context of public health problems associated with air pollution. Despite national survey data that indicate that the prevalence and severity of asthma has been increasing over the past 20 years, there is no consensus regarding the reasons for this increase. Furthermore, as more and more health studies identify relationships between increasing air pollution levels and increasing asthma morbidity, there is also a need for firmer understanding of this relationship at the local level. The second part of the presentation will describe a collaborative effort among the Lung Association, the Centers for Disease Control, and the Maine Bureau of Health to develop a prototype surveillance system for asthma in Maine.