How Published Evidence Informed Risk Communication in the Field Pertti (Bert) J. Hakkinen, Ph.D.

1. How Published Evidence Informed Risk Communicationin the Field Pertti (Bert) J. Hakkinen, Ph.D. Senior Toxicologist, and Toxicology and Environmental Health Science Advisor Deepwater Horizon Panel Monday, June 20, 2011 2:45 PM - 4:45 PM

2. DisclaimerGoals of Presentation • Introduction to NLM • Overview of NLM’s role in providing resources to decision-makers and responders • Description and impact of Wireless Information System for Emergency Responders (WISER) http://wiser.nlm.nih.gov/ • Additional relevant NLM resources • Relevant information from my non-NLM experiences

3. U.S. National Library of Medicine (NLM) NLM’s Mission: Collect, organize, and disseminate health-related information. • World’s largest biomedical library • Millions of items in collection • Services: PubMed, MedlinePlus and many others • Several hundred million searches of PubMed each year • Articles from several thousand journals indexed monthly • Research and Development • Biomedical informatics and communications • Relatively new focus (within Specialized Information Services): Disaster information

4. http://www.nlm.nih.gov/

5. The Specialized Information Services Division (SIS) of the NLM is responsible for information resources and services in: • Toxicology • Environmental health • Chemistry • HIV/AIDS, and • Specialized topics in minority and other special populations health • Disaster information http://sis.nlm.nih.gov/

6. Why have a Disaster Information Management Research Center at the NLM? • Need a central government agency that specializes in • providing information for disaster preparedness & response & research. • Experts in information management. • Long history of programs, partnerships for providing information for disaster preparedness & response.

7. To provide access to authoritative disaster health information to the U.S & world at all stages of disaster preparation, response, mitigation and recovery

8. Target Audiences • Librarians and other information professionals • Public health workers • Researchers • Emergency managers • First responders • Public and others

9. http://sis.nlm.nih.gov/dimrc.html

10. http://disaster.nlm.nih.gov/

11. Disaster and Emergency Response Tools • Wireless Information System for Emergency Responders (WISER) • Radiation Emergency Medical Management (REMM) • Chemical Hazards Emergency Medical Management (CHEMM)

12. Wireless Information System for Emergency Responders (WISER) http://wiser.nlm.nih.gov/

13. WISER http://wiser.nlm.nih.gov • Easy to use, intuitive • Information tailored to the specific needs and roles of emergency responders • Reliable, complete, and trustworthy information • Focus on unknown substance identification capabilities • Provide a platform that can be expanded to support other emergency response needs • Rich, stand-alone capability with enhanced connected (wireless) capabilities • Cross-platform, multi-device architecture

14. Who Uses WISER? HazMat First Responders/ Fire Fighters EMS/Paramedics ER personnel

15. What’s in WISER • Data on 400+ chemicals, 20+ radiologic agents, and CDC Category A biologic agents • Unknown substance identification • Tools and reference materials • Triage algorithms, ERG 2008 (ERG 2012 will be added when available), WMD Response Guidebook • Radiation procedure docs, Dose Estimator, Unit Converter • Support for key platforms

16. WISER Platforms – A Little History Windows Palm OS iPhone Windows Mobile WebWISER Blackberry Android Coming soon! • 16

17. What information sources are used in WISER? Hazardous Substances Data Bank (HSDB) WMD Response Guidebook CIDRAP 17

18. WISER Basics Either you know what you’re dealing with… … or you don’t! 18

19. Next Steps • WISER for Android • iOS universal support (iPad support) • Help Identify and Tools for iPhone, Android • Protective Distance for iPhone, Android, WebWISER 19

20. Get WISER! http://wiser.nlm.nih.gov

22. Additional Relevant NLM Resources

23. NLM-TOX-ENVIRO-HEALTH-L@LIST.NIH.GOV August 30, 2010 • Crude oil and dispersant records were added to the Hazardous Substances Data Bank (HSDB). http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?HSDB • “In response to the 2010 Deep Water Horizon oil spill, the HSDB development team and the HSDB Scientific Review Panel (SRP) compiled and reviewed data for crude oil, Corexit 9500, and Corexit 9527 records.” • HSDB records include data on human health effects, animal toxicity studies, environmental fate and exposure, and hazard information.

24. http://www.nlm.nih.gov/medlineplus/oilspills.html

29. http://disaster.nlm.nih.gov/dimrc/oilspills.html

30. Featured Sites Overviews Health Information Coping with Disasters and Stress Occupational Health Information Crude Oil Dispersants Seafood and Fisheries Contamination Response and Recovery Gulf State Agencies Involved in Prevention, Response, and Recovery Oil Spills and Wildlife Social Media Sites: Gulf Oil Spill Multi-language Resources Disclaimer

31. http://sis.nlm.nih.gov/enviro/envirohealthlinkscriteria.html

32. Purpose Authority, Credibility, and Affiliation

33. Content, Coverage, and Currency Point of View

34. Intended Audience Access, Navigation, and Availability Language Featured Sites

35. How to Stay Informed

36. How to Stay Informed

37. REFERENCES NLM “In Focus” eNewsletter. NLM Disaster-Response Tools: Helping Emergency Responders. September 30, 2010. http://infocus.nlm.nih.gov/2010/09/nlm-disaster-response-tools-he.html Hochstein C, Arnesen S, Goshorn J, Szczur M. Selected resources for emergency and disaster preparedness and response from the United States National Library of Medicine. Med Ref Serv Q. 27(1): 1-20 (2008). http://www.ncbi.nlm.nih.gov/pubmed/18689200

38. Relevant Information From My Non-NLM Experiences

39. Neil, Nancy, Paul Slovic, and P.J. (Bert) Hakkinen, 1993. Mapping Consumer Perceptions of Risk. Chemical Manufacturers Association. Sample Size: 750 subjects Method: 47 items judged by respondents on each of 15 evaluative scales, from large-scale multitopic study; two one-hour sessions over two days www.epa.gov/pesticides/regulating/labels/pdf/cliphase1-rpt.pdf

40. http://www.crcnetbase.com/doi/book/10.1201/9781420048735 Chapter 5. Industry’s Use of Risk, Values, Perceptions, and Ethics in Decision Making P . J . (Bert) Hakkinen and Carolyn J . Leep Handbook for Environmental Risk Decision Making Values, Perceptions, and Ethics Edited by C . Richard Cothern CRC Press 1996

41. http://www.ncbi.nlm.nih.gov/pubmed/15292907 Free full text: http://www.nature.com/jes/journal/v14/n7/full/7500392a.html

42. Hakkinen, P.J. 1993. Commentary about intuitive toxicology: expert and lay judgments of chemical risks. Comments on Toxicology 4: 505-509. http://www.sciencedirect.com/science/article/pii/B0123694000100067

43. Noteworthy findings from studies of intuitive toxicology in the United States, Canada, and the United Kingdom include: • The public: More likely to think that chemicals pose greater risks. Finds it difficult to understand the concept of dose–response relationships. Much more likely to think the results of animal carcinogenicity studies can be applied to humans. • Toxicologists: Much disagreement about how to interpret various results. Technical judgments were associated with factors such as place of employment, gender, and age… “…the results also suggest that disagreement among experts, especially as perceived by the news media and the public, can play a key role in controversies over chemical risks.”

44. Recap • Introduction to NLM • Overview of the National Library of Medicine’s role in providing resources to decision-makers and responders • Description and impact of Wireless Information System for Emergency Responders (WISER) http://wiser.nlm.nih.gov/ • Additional relevant NLM resources • Relevant information from my non-NLM experiences

45. Comments? Suggestions? Pertti (Bert) J. Hakkinen, Ph.D. National Library of Medicine, National Institutes of Health pertti.hakkinen@nih.gov