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KAY BECHTOLD is assistant editor of The Synergist. She can be reached at kbechtold@aiha.org or (703) 846-0737.
Explaining “Acceptable” Risk AIHA Fellow Seeks to Bolster Understanding of Risk Characterization, Management BY KAY BECHTOLD, ASSISTANT EDITOR, THE SYNERGIST
 
 
Editor’s note: The individuals featured in this series were selected from responses to a survey that AIHA conducted in 2014. For background, see "The IH Hero Gap" in the January 2015 issue.
 
He hikes technical trails. He mountain bikes. He’s backpacked extensively. He skis—both downhill and cross country. He feels in control, and he has fun. And yes, risk characterization and risk management expert Fred Boelter knows that a number of people would consider some or all of his outdoor adventures to be risky. But that’s how it works: people tend to take part in more risky activities personally than they are engaged in at the workplace. “I’m keenly aware that my personal activities are considerably riskier than much of the occupational work that I advise people on,” says Boelter, a consultant with more than 40 years’ experience. Boelter also enjoys less risky time spent with his wife, children, and grandchildren in Boise, Idaho, where he’s lived for two and a half years. A Chicago transplant, Boelter is thrilled to have the vast outdoors of Boise at his doorstep, which makes his favorite activities much more accessible. WIDE-RANGING WORK When he’s not out on the trails, Boelter works as a principal consultant at a new firm called RHP Risk Management Inc., where he provides clients with support in defining, analyzing, characterizing, assessing, and managing unacceptable risks—both occupational and non-occupational—to human health and the environment. As is the case for many consultants, Boelter’s work is broad. Clients hire him for wide-ranging reasons: they may have a question about compliance, they may want to do a root-cause analysis on a system failure, or they might face challenges meeting regulatory obligations in other countries. Throughout his career, Boelter has worked on projects in approximately two dozen other countries. “My clients range from risk tolerant to risk averse, but fundamentally they want to be doing the right thing,” Boelter says. “They want to be compliant, they want to treat their employees well, they want to produce a product, and they want to be able to stay in business.”
 
At the same time, Boelter has learned that clients don’t necessarily care about the industrial hygiene profession itself. It’s not that people don’t appreciate what industrial hygienists do, Boelter explains; it’s more that they don’t have a “true interest” in the scientific basis of IHs’ work and their professional judgment. “Professionally, we have a great need to define ourselves in terms that are meaningful to our clients, and I think often we don’t,” he says. “Often we define ourselves in ways that our clients perceive us as being a cost center, and I think that’s where there is a potential disconnect for our profession.”
“If we are professionally grounded in the historic concept of evaluating exposures, and if we are accustomed to comparing exposures against some allowable level of exposure, then is what we consider an allowable level today going to stand the test of time into the future?”
THE MEANING OF “ACCEPTABLE” RISK
The industrial hygiene profession has changed dramatically through the years, and the trends are familiar to those who have been practicing as long as Boelter. Industrial hygienists have worked continuously to improve upon the means and methods of characterizing exposures. In many industries, exposures have been reduced significantly. The nature of the workplace itself has changed: what it means to be an employee is different now, and in some ways more complicated given the increase in temporary and contracting work. And conditions that would likely be considered gross by today’s standards may have been compliant back when Boelter’s career began. “The expectations on the part of workers and on the part of the public are different today than they were 40-plus years ago, or even when AIHA was founded 75 years ago,” Boelter says. “And therefore what is considered acceptable has also changed.” “If we are professionally grounded in the historic concept of evaluating exposures, and if we are accustomed to comparing exposures against some allowable level of exposure, then is what we consider an allowable level today going to stand the test of time into the future?” Boelter asks. The idea of “acceptable” is a personal observation made by the individual, so while science and policy have helped create allowable limits and recognized standards to define what is acceptable, individuals’ perceptions, attitudes, and beliefs may or may not align with those definitions. And as industrial hygienists collect more and more information related to the totality of human environmental exposures—the exposome—they must figure out how to use that information to make sense of what is meant by acceptable, Boelter notes. The general public’s distrust of science heightens the challenge that industrial hygienists face in trying to effectively communicate to people what complex information means and why some level of exposure must be acceptable. When there’s no definition for “acceptable” chemical, physical, or biological exposure, it’s easy to conclude that any exposure is unacceptable. “To call everything bad is to call nothing bad, and that makes no sense in the real world,” Boelter says. “We are ultimately talking about humans, how humans think, and the basis upon which people make decisions about risk. Humans don’t think in technical terms, and yet technical is our professional domain, and we’re very comfortable and skilled with the technical work that we do.” MOTIVATION WITHOUT FEAR Boelter’s interest in risk has prompted him to move away from technical committee work—developing new methods or developing allowable limits, for example—and into behavioral matters, such as how to help people make informed decisions. He’s focused on developing more effective means for industrial hygienists to convey information so people can understand the risks involved in involuntary activities, such as in the workplace, and make informed decisions about personal, voluntary activities. Until recently, Boelter argues, industrial hygienists have relied on fear and raw data, presented without explanation to help the public make sense of it, to help people understand risk. “Much of the literature and many agency policy decisions are fear-based or couched as ‘no known safe level of exposure,’ and I don’t feel—professionally—we should use fear as a tool to get people to change their behaviors,” Boelter says. “While response to fear is hard-wired into our species and can be a great motivator, exposure science requires understanding hazards and making behavioral risk management changes to affect what is called being safe. Our profession, after all, is finding safe ways for people to work with hazards.” Boelter believes that there’s more than ample room for additional work on this broader topic of risk, which he acknowledges may be a bit ‘uncomfortable’ for industrial hygienists. “We’re not talking technical when we’re talking about human behaviors,” he says. “We are comfortable with technical, we are comfortable with numbers, and we would like more people to occupy the scientific and engineering space, but that’s not how humans think and it’s really not how humans make decisions. If a person feels safe, they are safe by their own measure. We want workers to understand and trust the science of health and safety so that we can model, measure, and confirm that they are safe.” THE RISK-REWARD RATIO Boelter has always been interested in what he recognizes as a risk-reward ratio—what others may call cost-benefit. He learned early on from his father, an entrepreneur with his own plumbing and heating business, that without risk, there is little potential for reward, and that humans are unable to advance without building on others’ previous experiences. That idea holds true not only in terms of how people succeed personally and in business, but also in the world of occupational health. “This risk-reward, cost-benefit relationship is one that is deeply ingrained in engineering, and it’s deeply ingrained in our profession in terms of protecting worker health and safety,” Boelter says. The question becomes “what is the reward associated with taking an occupational risk, or what benefit results to the employee as a result of the employer reducing risk?” Boelter praises industrial hygienists’ “marvelous capability” in the technical realm, which they can integrate into how decisions get made, both by businesses and enterprise risk management as well as by individuals. But that’s not easy given the public’s current attitude toward exposure. “Let’s not forget that we have helped the worker and the public, either consciously or unwittingly, to believe the idea that exposure is not good,” Boelter says. “With OELs and guidelines, we are at the same time trying to explain to workers and the public why a certain level of exposure is not bad. “People will say, ‘I don’t want any exposure,’ without realizing that there is no such thing as zero exposure. Therefore, there must be some level of exposure which is not unacceptable. Yet I don’t think we’re very good at explaining that concept to people.” For Boelter, enhancing the profession’s visibility and strengthening its relationship with the public are the first steps in helping people understand how industrial hygiene has improved health and safety, both occupationally and non-occupationally. “It is the nontechnical side of our work that I see to be of greatest importance for us to be focusing on professionally,” Boelter says. “We have this intersection between the scientific work that we do and the challenge of trying to communicate many of these difficult scientific concepts without confusing the public—at the same time, focusing on why the public should care about health and safety.”
 
RECOGNIZED RISK EXPERT A familiar face in the world of risk, Boelter, an AIHA Fellow, has been recognized for his contributions to the profession on numerous occasions. He received the AIHA Edward J. Baier Technical Achievement Award in 2005, and most recently he was the 2014 recipient of the Henry F. Smyth, Jr., Award, which honors individuals who have contributed to the public welfare by recognizing and fulfilling the needs of the industrial hygiene profession. Boelter is currently vice chair of AIHA’s Risk Assessment Committee. In recent years, Boelter, together with NIOSH Chief of Staff Frank Hearl and Adam Finkel, an expert on risk assessment and cost-benefit analysis at the University of Pennsylvania, helped resurrect an occupational health and safety specialty group within the Society for Risk Analysis, a membership society that provides an open forum for those interested in risk analysis. The revived specialty group focuses on risk analysis related to workers and workplaces. During his Smyth Award Lecture at the 2014 AIHA Fall Conference, Boelter explained what he sees as the key long-term challenges for the profession: to educate the general public on the difference between scientific understanding and opinion, and to get the public to care as much about protecting workers as they do about protecting the environment. “If risk is a core competency [of industrial hygiene], we have an important role to play in helping the public sort through data,” Boelter said during his presentation.
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Opposition to the use of Agent Orange in Vietnam was part of my motivation to move from chemistry to toxicology, and the insecticide parathion was part of my post-doctoral project. And I claim expertise (or at least experience) in this process by serving on two IARC working groups, and on National Toxicology Program (NTP) peer review groups for bioassay reports, the criteria for evaluating those bioassay reports, and the Report on Carcinogens (ROC).
 
- Frank Mirer
IARC Monographs Volumes 112 and 113 address insecticides and herbicides. They classify lindane as known to be carcinogenic to humans (Group 1); DDT, malathion, and diazinphos as probably carcinogenic (Group 2A); and 2,4-D, tetrachlorvinphos and parathion as possibly carcinogenic (Group 2B). Although few IHs work in agriculture, we are likely to get questions about pesticide use in homes and, regarding glyphosate, on our lawns.
 
- Frank Mirer
Editor's note: California followed suit in September, announcing its intention to list glyphosate as a carcinogen under Proposition 65.