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Strategic niche management and transition management have been promoted as useful avenues to pursue in order to achieve both specific product or process changes and system transformation by focusing on technology development through evolutionary and co-evolutionary processes, guided by government and relevant stakeholders. However, these processes are acknowledged to require decades to achieve their intended changes, a timeframe that is too long to adequately address many of the environmental and social issues many industrialized and industrializing nations are facing. An approach that involves incumbents and does not consider targets that look beyond reasonably foreseeable technology is likely to advance a model where incumbents evolve rather than being replaced or displaced . On the other hand, approaches that focus on creating new entrants could nurture niche development or deployment of disruptive technologies, but those technologies may only be marginally better than the technologies they replace. Either approach may take a long time to achieve their goals. Sustainable development requires both radical disruptive technological and institutional changes, the latter including stringent regulation, the integration of disparate goals, and changes in incentives to enable new voices to contribute to new systems and solutions. This paper outlines options for a strong governmental role in setting future sustainability goals and the pathways for achieving them. [ABSTRACT FROM AUTHOR]

Abstract: This article analyses the role of different kinds of information for minimizing or eliminating the risks due to the production, use, and disposal of chemical substances and contrasts it with present and planned (informational) regulation in the United States and the European Union, respectively. Some commentators who are disillusioned with regulatory approaches have argued that informational tools should supplant mandatory regulatory measures unflatteringly described as “command and control.” Critics of this reformist view are concerned with the lack of technology-innovation forcing that results from informational policies alone. We argue that informational tools can be made more technology inducing – and thus more oriented towards environmental innovations – than they are under current practices, with or without complementary regulatory mechanisms, although a combination of approaches may yield the best results. The conventional approach to chemicals policy envisions a sequential process that includes three steps of (1) producing or collecting risk-relevant information, (2) performing a risk assessment or characterization, followed by (3) risk management practices, often driven by regulation. We argue that such a sequential process is too static, or linear, and spends too many resources on searching for, or generating information about present hazards, in comparison to searching for, and generating information related to safer alternatives which include input substitution, final product reformulation, and/or process changes. These pollution prevention or cleaner technology approaches are generally acknowledged to be superior to pollution control. We argue that the production of risk information necessary for risk assessment, on the one hand, and the search for safer alternatives on the other hand, should be approached simultaneously in two parallel quests. Overcoming deficits in hazard-related information and knowledge about risk reduction alternatives must take place in a more synchronized manner than is currently being practiced. This parallel approach blurs the alleged bright line between risk assessment and risk management, but reflects more closely how regulatory agencies actually approach the regulation of chemicals. These theoretical considerations are interpreted in the context of existing and planned informational tools in the United States and the European Union, respectively. The current political debate in the European Union concerned with reforming chemicals policy and implementing the REACH (Registration, Evaluation and Authorization of Chemicals) system is focused on improving the production and assessment of risk information with regard to existing chemicals, although it also contains some interesting risk management elements. To some extent, REACH mirrors the approach taken in the United States under the Toxics Substances Control Act (TSCA) of 1976. TSCA turned out not to be effectively implemented and provides lessons that should be relevant to REACH. In this context, we discuss the opportunities and limits of existing and planned informational tools for achieving risk reduction. [Copyright &y& Elsevier]

The Precautionary Principle is in sharp political focus today because (1) the nature of scientific uncertainty is changing and (2) there is increasing pressure to base governmental action on more “rational” schemes, such as cost-benefit analysis and quantitative risk assessment, the former being an embodiment of ‘rational choice theory’ promoted by the Chicago school of law and economics. The Precautionary Principle has been criticized as being both too vague and too arbitrary to form a basis for rational decision making. The assumption underlying this criticism is that any scheme not based on cost-benefit analysis and risk assessment is both irrational and without secure foundation in either science or economics. This paper contests that view and makes explicit the rational tenets of the Precautionary Principle within an analytical framework as rigorous as uncertainties permit, and one that mirrors democratic values embodied in regulatory, compensatory, and common law. Unlike other formulations that reject risk assessment, this paper argues that risk assessment can be used within the formalism of tradeoff analysis—a more appropriate alternative to traditional cost-benefit analysis and one that satisfies the need for well-grounded public policy decision making. This paper will argue that the precautionary approach is the most appropriate basis for policy, even when large uncertainties do not exist, especially where the fairness of the distributions of costs and benefits of hazardous activities and products are a concern. Furthermore, it will offer an approach to making decisions within an analytic framework, based on equity and justice, to replace the economic paradigm of utilitarian cost-benefit analysis. [ABSTRACT FROM AUTHOR]

The Precautionary Principle is in sharp political focus today because: 1) the nature of scientific uncertainty is changing,and 2) there is increasing pressure to base governmental action on more "rational" schemes, such as cost-benefit analysis and quantitative risk assessment, the former being an embodiment of "rational choice theory" promoted by the Chicago School of Law and Economics. The Precautionary Principle has been criticized as being both too vague and too arbitrary to form a basis for rational decision making. The assumption underlying this criticism is that any scheme not based on cost-benefit analysis and risk assessment is both irrational and without secure foundation in either science or economics. This paper contests that view and makes explicit the rational tenets of the Precautionary Principle within an analytical framework as rigorous as uncertainties permit, and one that mirrors democratic values embodied in regulatory, compensatory, and common law. Unlike other formulations that reject risk assessment, this paper argues that risk assessment can be used within the formalism of tradeoff analysis - a more appropriate alternative to traditional cost-benefit analysis and one that satisfies the need for well-grounded public policy decision making. This paper will argue that the precautionary approach is the most appropriate basis for policy, even when large uncertainties do not exist, especially where the fairness of the distributions of costs and benefits of hazardous activities and products are a concern. Furthermore, it will offer an approach to making decisions within an analytic framework, based on equity and justice, to replace the economic paradigm of utilitarian cost-benefit analysis. [ABSTRACT FROM AUTHOR]

Inherent Safety is generally recognised as an important concept in the design of chemical plants. It is, however, often regarded as the sole province of engineers. Inspired by the successful development in the last decade from cleaner technology towards Cleaner Production, we explored in this research the feasibility of what we call Inherently Safer Production. Four pilot cases were carried out, two in the Netherlands and two in Greece; three in existing plants, one at the design stage. A methodology to generate inherently safer technological options was developed and tested. In all four cases, a number of options for inherently safer production were identified, while more traditional safety options were also identified. The great majority of options was shown to have pay back times of less than 2 years. Overall, 25% of the options were implemented during the project.In existing plants, the option generation process can be organised as a collective learning and inspiring effort. This can be of considerable value on its own, apart from the implementation of the (technological) options identified. We conclude that Inherently Safer Production is a feasible concept, that it has great potential for simultaneous improvement of safety and economic performance, and that it deserves to be further developed. [Copyright &y& Elsevier]

This article challenges certain tenets of the theories of reflexive law and ecological modernization. Although farsighted prevention-oriented and structural changes are needed, some proponents of these theories argue that the very industries and firms that create environmental problems can through continuous institutional learning, the application of life-cycle analysis, dialogue and networks with stakeholders, and implementation of “environmental management systems” be transformed into sustainable industries and firms. Although useful, these reforms are insufficient. It is not marginal or incremental changes that are needed for sustainability but rather major product, process, and system transformations—often beyond the capacity of the dominant industries and firms. This article also questions the alleged failure of regulation to stimulate needed technological changes and identifies the conditions under which innovation for sustainability can occur Finally, it discusses differences in needed policies for industrialized and developing countries. [ABSTRACT FROM AUTHOR]

Evaluates the use of SimpliRED D-dimer assay in the identification of patients with deep vein thrombosis. Reduction in the requirement for radiology; Sensitivity of SimpliRED assay; Improvement in the detection of high-risk patients.

Focuses on two US Environmental Protection Agency's (EPA) policies that encourage the inclusion of pollution prevention in regulatory enforcement settlements. Reduction of environmental problems at the source; Enhancement of prospects for compliance; Potential for a reduction in the assessed penalty.

A letter to the editor is presented in response to the article "Variation in cancer risk among tissues can be explained by the number of stem cell divisions" by Cristian Tomasetti and Bert Vogelstein in the January 2, 2015, issue.

Points out that human exposure to chemicals at low levels can be harmful. Link between chemicals and public health problems; Problem characterization; Strategic approach to the problem. INSET: Evolution of scientific knowledge.

A letter to the editor is presented in response to the article "Mass Psychogenic Illness Attributed to Toxic Exposure at a High School," by T.F. Jones and colleagues, previously published in the January 13, 2000 issue of the "New England Journal of Medicine."

Purpose: The purpose was to determine (1) how well doctors' assessments of patients matched the patients' own self assessments and (2) what doctors looked for in terms of patient factors (such as pain and dysfunction, radiographic evidence) that influenced their decisions to allocate priority for hip replacement. Method: Data collected independently from patients and surgeons after consultation were used to investigate medical decision-making. Patients were 74 consecutive patients who were offered total hip replacement in an orthopaedic outpatient department at a single hospital. Main measures were (1) assignment to priority group; (2) surgeons' ratings of patient pain, function, stoicism and predicted benefit; (3) patients' pain ratings, function (Arthritis Impact Measurement Scale) and timed walk, and predicted benefit; (4) hip radiographs were assessed independently using composite grading scores. Results: Surgeon- and patient-rated current pain and function were reasonably correlated; predicted benefit from surgery in pain and function were not, although surgeons predicted greater benefit. High priority for surgery was associated with higher surgeon-rated patient pain and function, by higher pain ratings by patients, more severe radiographic abnormalities, by being female and over 70. Some patients with relatively low pain scores and low levels of dysfunction were offered hip replacements. Conclusions: Doctors made reasonable estimates of patients' pain and function by direct history taking and examination. There was no systematic underestimation of patients' pain, in contrast to previous studies. Doctors' estimate plus radiological changes account for most of the priority differences. Patients' and surgeons' expectation of improvement, relatively unrelated to severity of pain and dysfunction, in the absence of agreed minimal clinical criteria, may drive surgical demand. There was a wide range in measures of pain and function. Introduction of formal... [ABSTRACT FROM AUTHOR]

Explores the differences in protection from hazards given to workers and to the general public in the U.S. Discussion of airborne lead as an example of such differential protection; Adoption of the community ambient air quality standard by the U.S. Environmental Protection Agency; Aspects of the governmental or legal intervention in the toxic substances area; Requirements of the Clean Air Act. INSET: PRINCIPLES OF JUSTICE.