•  Safety

Risk: A Practical Guide for Deciding What's Really Safe and What's Really Dangerous in the World Around You
By David Ropeik and George Gray
Houghton Mifflin Co.
$16 485 pp

When I first picked up Risk: A Practical Guide for Deciding What's Really Safe and What's Really Dangerous in the World Around You, I immediately flipped to the chapter on caffeine and felt modestly relieved to learn that I was not unduly harming my health with two daily lattes. Next, I checked the section on microwaves to discredit my (somewhat paranoid) housemate's fears of being zapped by high levels of radiation every time I made some pasta.

Not that I was likely to give up my daily coffee fix, nor abandon my quick heating methods no matter what I found out. And that's what makes Risk a fun book to have around for a factoid kind of person like me: I love stumbling across random snippets of information, even when these tidbits have little impact on my life.

And Risk is, more or less, an almanac of death, a fascinating, if incomplete survey of the events, bugs, and materials that are likely to kill us, or at least potentially cause serious injury. I mean how, exactly, does mercury affect the body? How do incinerators work? Why are there so many medical errors in hospitals? If I didn't know the answers to these questions before, I do now.

The authors, David Ropeik and George Gray, are both affiliated with the Harvard Center for Risk Analysis, a research institute at Harvard University's School of Public Health. They do an especially good job of providing background and context for many of the dangers we worry about, whether from medical or environmental sources, or from simple modern conveniences. But Ropeik and Gray are appropriately humble about the task they have set out to accomplish, and they perform a valuable service in exploring, with a thorough and thoughtful introduction, the inherent complexities of measuring risk.

"First, the sciences by which risk is investigated -- toxicology, epidemiology, and statistical analysis -- are inherently imprecise," they write. "Second, there are a lot of risk questions science simply hasn't asked yet. ... And third, even for risks that have been studied, the facts as we know them are constantly changing as scientific answers to one set of questions reveal more questions. ... In short, our effort in this book to give you an accurate, reliable explanation of many of the risks you face is tantamount to shooting at a moving target."

This book is clearly not designed to be read cover to cover. Most people will likely browse through it and focus on the chapters addressing the particular topics that interest -- or frighten -- them the most. And experience clearly suggests that many people are unlikely to change their behavior no matter what they find out.

For example, by any measure, flying remains -- even after 9/11 -- a far less risky proposition than, say, the simple act of riding in a car. But the people who cut back on airplane travel in the past couple of years have probably not simultaneously reduced their time on the roads, and still others won't bother to fasten their seat belts. Similarly, many people get vaccines every year to protect themselves from influenza, but don't manage to quit smoking or start an exercise program -- even though cigarettes and obesity clearly contribute to an enormous number of life-threatening illnesses.

The authors have divided their chosen topics into three broad categories: home, the environment, and medicine. The first section -- covering home, transportation, and work -- includes chapters on the dangers of air bags, school buses, firearms, and electromagnetic fields. The segment on the environment features the hazards of indoor and outdoor air pollution, incinerators, lead, pesticides, and solar radiation, among other things. And the third section, on medical risks, covers things like mammography, medical errors, vaccines, and x-rays. Each chapter examines the exact nature of the hazard, then lists possible exposures, the range of consequences, and ways individuals can reduce their risk.

Although the book is essentially a compendium of the authors' own idiosyncratic judgments, they assure readers that they have vetted their own instincts by finding at least one, and often two, experts on the topic under discussion to review the material for accuracy. The names of these experts are provided at the end of each chapter, as are organizations and Web sites that can provide more information on the subject.

The assessments in Risk must clearly be taken with a lump rather than a grain of salt. As the authors emphasize, the risk of any given danger varies greatly among individuals, depending upon lifestyle, place of residence, personal history, and so on. In any event, what I found most enjoyable about the book was not the information about specific risks per se; it was learning why certain things were considered risks in the first place. I'd heard about the dangers of radon, for example, but never had any idea just what it was, where it came from, why it was bad, and why it appeared in the basements of homes rather than, say, attics. (If you want to know, turn to page 294.)

I was also intrigued to learn that in Massachusetts, an estimated 2.4 million prescriptions are incorrectly filled annually (page 378); that there are hundreds of incinerators in the United States specifically designed for medical waste (page 236); that people between the ages of 15 and 24 are at greater risk of dying from an unintentional gunshot than people in other age groups (page 95); and that falls are the most common cause of accidental death in the country, killing about six people per 100,000.

But this book shouldn't be taken as gospel -- nor do the authors expect anyone to do so. As they freely acknowledge, the perception of risk is inherently subjective.

"Ultimately we react to risk with more emotion than reason," they write. "We take the information about a risk, combine it with the general information we have about the world, and then filter those facts through the psychological prism of risk perception. What often results are judgments about risk far more informed by fear than by facts."

-- David Tuller reports regularly on health for The New York Times. A former staff writer for the San Francisco Chronicle, he has written for the Washington Post and Salon.com and is the author of Cracks in the Iron Closet: Travels in Gay and Lesbian Russia (Faber &Faber 1996).

First published May 5, 2004
Last updated October 30, 2008
Copyright © 2004 Consumer Health Interactive

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