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Risk perception, risk taking and risk management among intravenous drug users: implications for AIDS prevention.

The risks associated with AIDS transmission among intravenous drug users overlap with a constellation of other risk events common in the use of IV drugs. This paper explores the subcultural definition, meaning and use of risk from the experience of the active user. In assessing the extent and nature of risk among IV drug users, street-based ethnographic research was conducted over a sixteen month period and a survey was administered to sixty-six individuals in two drug treatment facilities. Risk-taking, risk perception and strategies for minimizing risks associated with maintaining a drug habit are analyzed in the context of how IV drug users are responding to the risks associated with HIV transmission. The research indicates that risk needs to be viewed within the context of the subculture to effect strategies to reduce HIV-related risk behavior.

Acquired Immunodeficiency Syndrome

Adolescents' smoking behavior and risk perceptions.

Risk-perception theory, derived largely from studies of technological risk assessment by Slovic and associates (Slovic, 1987; Slovic, Fischhoff, & Lichtenstein, 1986), may assist in understanding the risks seen to be associated with health-related behaviors. Risk perceptions, and their relationship to different stages of the acquisition of smoking behavior, were examined in a sample of 205 Australian high school students who were in Grades 10 and 11, and had an average age of 15 years. Current smokers differed from experimenters, ex-smokers, and never smokers on a number of factors that are argued to underlie perceptions of risk: They perceived less personal risk, less severe health consequences, greater benefits relative to risks, found it more difficult to picture harmful consequences to themselves, and perceived smoking to be less avoidable. Implications for understanding and for dealing with the initiation and maintenance of smoking behavior in adolescence are discussed.

Adolescent

Industrial risk perceptions.

The risks of occupational exposure to radiation need fuller and more explicit characterization. They also need a more developed quantitative comparison with more familiar occupational hazards. To achieve this, some criterion is needed for establishing the amount of detriment one should attribute to different harmful effects, e.g., from accidents at work which cause death, temporary or permanent disability; from fatal and nonfatal cancers; from developmental abnormalities and any likely nonstochastic effects; and from a range of genetic defects. No such criterion for comparing incommensurable kinds of harm can be scientifically defined, but one is essential if occupational exposure standards are to be put into perspective. A comparison of the frequency of fatal cancers and "severe" genetic defects with that of accidental deaths at work is admittedly incomplete. One possible starting point is from a review of the average length of healthy life and activity lost as a result of nonfatal industrial accidents and some curable cancers, or of gross impairment during the course of an active disease or as a result of many types of genetic defect, or of life expectancy lost absolutely owing to fatal accidents and diseases. Estimates are discussed to emphasize the areas in which opinion is most needed to translate measures of risk based simply on total time lost into acceptable criteria of perceived detriment. Standards of industrial safety are reviewed on this basis, both for risk from accidents at work and from radiation exposure, with evidence on the rate at which both types of risk are being reduced.

Abnormalities, Radiation-Induced

AIDS-related risk perception and sexual behaviour among sexually transmitted disease clinic attenders.

Perception of risk has been suggested as an important element of sexual behaviour change among people who engage in behaviours which place them at risk of HIV infection. A study of the relationship between perception of risk of HIV infection and risk-related sexual behaviours was conducted in a genitourinary medicine clinic. The sample comprised 767 patients attending over a 3-month period; data collection was by self-completed questionnaire. A total of 574 questionnaires were suitable for analysis, representing a response rate of 75%. The majority of people in the sample reported behaviours which increased their risk of HIV infection, but only 19% (n = 112) of the sample perceived themselves to be personally 'at risk', despite adequate knowledge of HIV transmission and methods of risk reduction. Significant differences between social class groups were found for knowledge scores, with highest scores among professionals and lowest among unemployed subjects (Kruskal Wallis test chi 2 = 24.6, P less than or equal to 0.001). Increasing age was significantly associated with better knowledge; significantly more young people aged 16-20 years who did not perceive themselves 'at risk' (64%), had lower knowledge scores than older people who did not perceive themselves 'at risk' (41%). Among heterosexuals who reported having sex with other people in addition to their regular partner, 79% did not perceive themselves as 'at risk' of HIV infection, and of these, 64% reported only infrequent condom use with casual sexual partners. Significantly more heterosexual men (67%) than women (44%) reported multiple sex partners.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome

Predictors of risk perceptions of childhood injury among parents of preschoolers.

This article assesses the relationship between parents' perceived risk of childhood injuries and familial, sociocultural, and situational variables. Data were obtained through a random digit dial telephone survey of 1,200 households with a preschool child in a southeastern metropolitan area. Perceived risks of childhood injury measures were based on social science theory and childhood injury epidemiology. Multiple item measures included dimensions of seriousness and likelihood for both injuries and hazards. When risk perceptions were viewed as individual items, parents underestimated the risk of some hazards and injuries and overestimated the risks of others, and parents whose children have sustained a recent injury had higher risk perception overall. When risk perceptions were viewed as summed scales, sociodemographic variables and parental safety behaviors were not significant predictors. Sociocultural factors of having a child previously injured, the parent reporting stress, having a household with self-reported risk factors, and the perception of the child as active and hard to manage are related to summed scales of risk perceptions, with some interactions by race of the parent. Findings illustrate the role of situational and sociocultural characteristics of respondents in risk perception research.

Attitude to Health

Powerline frequency electric and magnetic fields: a pilot study of risk perception.

The perception of the potential risk arising from human exposure to 50/60 Hz electric and magnetic fields was studied with a quasi-random sample of 116 well-educated, opinion leaders using the risk perception framework previously developed by Slovic, Fischhoff, and Lichtenstein. These individuals rated exposure to fields from transmission lines and electric blankets on a variety of scales that have been found useful in characterizing people's risk attitudes and perceptions. These judgments allowed us to conjecture about the likely desire for regulation of these potential hazards and the likely response to a publicized problem (e.g., an accident or ominous research finding) involving these two sources of exposure. Various forms of detailed information about 50/60 Hz fields were supplied to respondents. The provision of information produced modest, but statistically significant, changes in perceptions in the direction of greater concern about the risks. In response to questions of public policy, participants desired modest regulatory control of field exposure from transmission lines and little or no control of field exposure from appliances like electric blankets.

Electric Injuries

Risk assessment, risk perception and decision making about courses of action involving genetic risk: an overview of concepts and methods.

Developments in medical diagnostics and shifts in the ethics of human reproduction increasingly present prospective parents with deliberate choice problems involving possible child deficiencies. An adequate handling of such problems may be supported by explicit methodologies for judging risks and making decisions under uncertainty. The paper gives an overview of concepts, models and methods concerning risk analysis, risk perception and "good" decision making. Several different (stimulus) definitions of risk are presented, and it is shown that "perceived risk" (a response-defined concept) may be operationally measured at different levels of an organism's activity. Disputes on the meaning of probability statements are related to differences in the available information basis which may result from a combination of frequentistic/nonfrequentistic data about, and external/internal determination of possible consequences. After a listing of various notions of "acceptable risk", three different approaches towards making good decisions are discussed. The paper concludes with a summary and some suggestions for the improvement of genetic counseling procedures.

Decision Making

Hostility to people with AIDS: risk perception and demographic factors.

The objectives of this investigation were to determine the associations between perception of AIDS risk, demographic and socio-economic variables and hostility to PWA's. Factor analysis and multiple regression models were used to examine telephone survey data. The principal results show a strong positive association between hostility to PWA's and perception of high AIDS risk from low-risk activities, and between hostility and: non-Hispanic respondents, low-income respondents, respondents with less than a high school education, male respondents and respondents living in rural areas. Conclusions speak for a need for understanding of the multiple outcomes of educational campaigns, pretesting of educational campaigns across multiple populations, and continued study of risk perception, hostility and the effects of stigmatization.

Acquired Immunodeficiency Syndrome

Knowledge and risk perception among nuclear power plant employees.

This is a study of knowledge, risk perception, and attitudes among nuclear power plant employees. A total of 236 persons participated, belonging to 10 different professional groups and working at two Swedish power plants. Job-related radiation risks were judged about average as compared to a number of other risks. On the whole, the participants in the study were satisfied with the measures of safety at work, but there were some exceptions to this rule, especially among those hired for temporary jobs through external contractors. The experience of job-related radiation risks was related to the level of knowledge about radiation and its risks: those who knew less experienced larger risks. General level of anxiety did not correlate with risk perception. The latter was accounted for mainly by perceived radiation risks. Job satisfaction was more strongly related to perceived conventional job risks than to nuclear risks. Risk ratings were related to how subjects defined the concept of risk. Those who stressed consequences as part of their risk definition gave higher risk ratings.

Accidents

Cross-cultural differences in driver risk-perception.

This study investigated differences in risk-perception among U.S., Spanish, West German, and Brazilian drivers. Subjects estimated the risk involved in slide-projected traffic scenes. The scenes, photographed in the United States and Spain, were rated for the amount of risk by using a seven-point scale. The subject groups in each country included younger, middle-aged, and older nonprofessional drivers, as well as middle-aged professional (bus, taxi, or truck) drivers. In the data analyses, the independent variables were subjects' country, age, professional driving experience, and sex, and 23 dichotomously coded characteristics of the traffic scenes. The following are the main findings: (1) Spanish drivers reported the highest risk, while U.S. drivers reported the lowest risk; (2) younger drivers tended to report lower risk than middle-aged and older drivers; (3) nineteen of the 23 analysed characteristics of traffic scenes contributed significantly to risk ratings, even after simultaneously controlling for the effects of all other scene characteristics; (4) ten scene characteristics had a differential effect on the risk ratings in the four tested countries; (5) two scene characteristics had a differential effect on the risk ratings in the four tested subject groups; (6) none of the variables affected differentially the risk ratings of professional vs. nonprofessional drivers and males vs. females. These findings provide information concerning the desirable country- and age-specific emphasis in driver education, driver licensing, and public information campaigns.

Accidents, Traffic

Risk perception and age-specific accidents of young drivers.

Accident risk involved in 100 slide-presented traffic situations was rated by 208 male and 100 female drivers in the age groups 18-21, 35-45, and 65-75 years. The main finding is that young male drivers rated the traffic situations as less risky than did older male drivers. This was especially the case for situations involving the following aspects: darkness, inclining/declining or curved roadways, and rural environment. No comparable age effect was present for females. These findings are in agreement with findings from accident studies, showing overinvolvement of young males in single-vehicle accidents that are characterized by the above mentioned aspects. The results show that educational measures for young drivers should emphasize different aspects for young men and young women and especially that young men's risk perception (as well as their risk tolerance) in those situations mentioned above must be made part of further efforts.

Accidents, Traffic

Fishing a superfund site: dissonance and risk perception of environmental hazards by fishermen in Puerto Rico.

Risk perception studies show that individuals tend to underestimate significant risks, overestimate negligible ones, and distrust authorities. They also rely on a variety of strategies or heuristics to reach decisions regarding their risk-taking behavior. We report on a survey of fishermen and crabbers engaged in recreational and substance fishing in a Puerto Rican estuary (near Humacao), which has been declared a "Superfund site" because of suspected contamination by mercury, and at ecologically similar control sites. Nearly everyone interviewed at the Humacao site was aware of the mercury contamination, but either denied its importance, believed the contamination was restricted to a distant part of the estuary, or assumed that the estuary would be closed by the authorities if the threat was real. All site-users consumed the fish and crabs they caught. At Humacao, the average catch was 7 fish per fishermen (mostly tilapia, Tilapia mossambica, and tarpon, Megalops atlantica) and 13 crabs per crabber (all blue crabs, Callinectes sapidus). On average, the site-users returned to the lagoons about 3-4 times per month. At control sites, fewer fish were eaten. The worst case consumption of tarpon, a species which concentrated mercury at Eastern Puerto Rico, provided an exposure exceeding the EPA reference dose, whereas consumption of one tarpon per week did not entail excess exposure. Fortunately, few individuals caught tarpon exclusively. Unlike counterparts in the northeastern United States, they trusted authorities and indicated that they would have heeded warnings of mercury contamination posted where they fished.

Animals

Relapse and risk perception among members of a smoking cessation clinic.

Assessed perceptions of the health risks associated with smoking in comparison with not smoking among members of smoking cessation clinics. We measured these perceptions at three different time periods during the clinic, and then again at a 6-month follow-up. Results indicated that members who were abstinent at the follow-up had lowered their perceptions of the likelihood of contracting smoking-related illnesses (e.g., emphysema) if they were not smoking. In contrast, those who had relapsed lowered their perceptions of the health risks associated with smoking, but not their perceptions of nonsmoking disease vulnerability. The implications of these changes in risk perception for therapy involvement are discussed.

Adolescent

The influence of flight experience on midair collision risk perception.

Although successful collision avoidance is presumed a learned skill, midair collision accidents typically involve highly experienced pilots. It is hypothesized that pilot complacency, arising from a history of incident-free flights, plays a role in the midair collision process. Pilot risk perception is explored using Laplace's Law of Succession, and the resulting perceived collision probability compared to reality. The two converge at around 5,000 hours of flight experience.

Accidents, Aviation

Risk perception and the value of safety.

This paper examines the relationship between perceived risk and willingness-to-pay (WTP) for increased safety from technological hazards in both conceptual and empirical terms. A conceptual model is developed in which a given household's WTP for risk reductions is a function of traditional socioeconomic variables (i.e., income and base level of risk) and perceived characteristics of the hazards (i.e., dread, knowledge, and exposure). Data to estimate the model are obtained through a combined contingent valuation and risk perception survey that considers 10 technological hazards, five of which are well-defined (e.g., death rates are known and the risks are relatively common) and five are less well-defined. Econometric results, using TOBIT estimation procedures, support the importance of both types of variables in explaining WTP across all 10 hazards. When the risks are split into two groups, the results show that WTP for well-defined hazards is most influenced by perceived personal exposure, while WTP for less well-defined risks is most influenced by levels of dread and severity.

Data Collection

Differences in Radiological Risk Perceptions Following Online and In-Person Workshops.

Nuclear energy is widely regarded as a critical part of the pathway toward a secure, low-carbon electricity grid, yet long-term management of used nuclear fuel remains a persistent challenge. Although technically viable options for interim and consolidated storage exist, public concern and community opposition - rooted in historical distrust and risk perception - continue to complicate siting decisions. In response, recent federal efforts have emphasized collaboration-based approaches and community engagement, though empirical evidence on the effectiveness of different engagement strategies remains limited. This study examines how the structure and delivery of community engagement influence changes in public attitudes toward hosting interim used nuclear fuel storage facilities. Using survey data from 13 educational workshops around the United States, we evaluate: (1) the inclusion of trust-building content prior to technical content, and (2) engagement format, comparing online and in-person workshops. Analyses focus on participant changes in perceptions of safety, risk, and support for hosting, using the Wilcoxon rank-sum test and other non-parametric hypothesis tests on surveys conducted before and after workshops. Results indicate that workshop participation is associated with some measurable attitude changes, with significant (p < 0.05) differences in response variability for some questions across workshop formats. In particular, when comparing nuclear energy to other clean energy sources, in-person workshop participants are substantially more likely to gain a more favorable opinion of nuclear energy than online participants. These findings contribute empirical evidence on how trust-building and delivery mode shape outcomes in public engagement on complex and contested energy policy issues such as storage of used nuclear fuel.

nuclear fuel cycle

Postpartum patients' knowledge, risk perceptions, and behaviors pertaining to childhood injuries.

The purpose of this study was to assess postpartum patients' knowledge, risk perceptions, and behaviors pertaining to a variety of childhood injuries. Although the respondents did demonstrate some knowledge of injury prevention strategies, deficits were noted in the areas of burns, motor vehicle injuries, drownings, and falls, as well as in the concept that injuries, in some children, are unavoidable. Results showed that greater than 50% of mothers did not know the temperature of their hot water tank, 22.4% who had other children under the age of four did not use car safety seats with them, and only 43% of the mothers knew how to perform infant cardiopulmonary resuscitation. Recommendations for program development in parenting classes are included in addition to the roles of nurses and nurse-midwives in injury prevention program activities.

Accident Prevention