Implications of Uncertainty for Establishing Protection Standards for Beryllium. T. K. Takaro, Department of Environmental Health and School of Medicine, University of Washington, Seattle, WA; R. A. Ponce and E. M. Faustman, Department of Environmental Health, University of Washington, Seattle, WA; G. S. Omenn, School of Medicine, University of Michigan, Ann Arbor, MI; and S. M. Bartell, Department of Environmental Health, University of Washington, Seattle, WA
One means for rational decision making when confronted with uncertain information is to use decision analysis. When applied to establishing worker protection standards, one might choose to use risk reduction maximization as the basis for selecting among several alternatives. However, the implementation of decisions established in this way may not be broadly accepted and may challenge currently accepted ethical norms. We present results from a value-of-information analysis applied to decisions regarding worker protection from chronic beryllium disease (CBD), which has a high prevalence among Be workers, particularly machinists. Among decision alternatives are included the use of genetic information regarding worker susceptibility to CBD and the use of clinical testing for beryllium sensitization applied to US DOE beryllium exposed workers. The analyses demonstrate that the use of individual genetic information to screen out susceptible individuals from working with beryllium has the highest utility in terms of risk reduction. We discuss the ethical issues surrounding mandatory and voluntary genetic screening to reduce CBD prevalence as balanced against the high prevalence of CBD that currently results from not using such genetic information in worker protection programs.
This work was supported by the Consortium for Risk Evaluation with Stakeholder Participation (CRESP) by Department of Energy Cooperative Agreement #DE-FC01-95EW55084. This support does not constitute an endorsement by DOE of the views expressed.
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