Key attributes of health and environmental risk decision-making: A scoping review.

Abstract

Government agencies, international institutions, and independent experts have published approaches for the assessment and management of health and environmental risks. This includes evidence-based strategies and publications supporting risk decision-making frameworks reflecting contemporary practices, the overarching context, and governance structures for addressing known and emerging risk issues. This scoping review surveys the literature, over the last five decades, to identify key attributes of health and environmental risk decision-making and how these inherent characteristics are related to the overarching regulatory decision-making context. The findings provide insights on how these publications accounted for the circumstances and triggers at that time. This includes incorporating factors reflecting advances in science and technology, a better understanding of underlying values (e.g., societal), and an expansion in the scope and complexity required for conducting different evaluations relevant to health and environmental risks. Consequently, the evolution from linear to more expanded and holistic decision-making frameworks incorporates foundational elements, such as the well-established steps for assessing risks, while adding aspects reflecting transformative changes and paradigm shifts (e.g., the use of non-animal testing strategies for evaluating human safety). Our analysis also resulted in the generation of a consolidated listing of ten attributes: trigger/issue, regulatory context, regulatory factors, core values, risk decision-making principles, cross-cutting attributes, design (scope and steps), structure, decision-making pathway, and evidence-knowledge requirements for risk decision-making. A better understanding of this evolution in risk decision-making and the listing of key attributes will be used in future work aimed at developing considerations for next generation decision-making approaches for health and environmental risks.