Americans more likely to die by drowning than by anthrax exposure Reacting to risk factors

Posted: Tuesday, October 23, 2001

Baruch Fischoff chuckles when he thinks about it. On Sept. 10, he spent some time with a reporter for The New York Times, talking about the risk of shark attacks.

''It was the last day of another era,'' he says.

On Sept. 10, we worried about shark attacks and fatty diets, ticks carrying Lyme disease and drivers talking on cellular phones. Then, suddenly, these risks seemed remote, replaced by hijacked jets plummeting from the skies, and -- within weeks -- by insidious, poisonous letters.

The reaction?

Americans demanded the antibiotic Cipro from Mexican pharmacies which dispense drugs without prescriptions. A factory in Auburn, Neb., closed for two days after a worker found a powder at the end of a roll of toilet paper in the men's room. Planes flew half empty. Commuters fretted -- would their train pass through a tunnel at the moment a terrorist's bomb went off?

All of these things and more, though it seems unlikely that terrorism will kill as many Americans as do motor vehicle accidents (42,191 in 1998) or poisonings (10,801).

In a posting this past week on an Internet bulletin board for infectious disease epidemiologists, science writer Ed Regis noted that about 300 Americans are killed each year by drowning in bathtubs, and in 1991, 1,247 died by inhalation or ingestion of food.

''In other words,'' he wrote, ''you are far more likely to die by taking a bath or eating your dinner than by opening an anthrax-laced envelope.''

Yet experts on risk perception like Fischoff, a professor at Carnegie Mellon University in Pittsburgh who studies human judgment and decision making, say these are reasonable responses, under the astonishing circumstances.

''You get disproportionate perceptions of risk,'' says Fischoff, but that is understandable: ''People don't like situations where they think that things might be out of control, where the information isn't very good.''

And the fact is, bad things are happening -- media attention is not necessarily exaggerating this story. Millions did see the World Trade Center vanish in flame and dust; people are being exposed to anthrax in highly visible places, in the media and government.

''Whoever is responsible for these attacks, they're brilliant'' in the way they are choosing the targets for anthrax-laced envelopes, says David Murray, research director for the Statistical Assessment Service in Washington. ''They've taken a very small fire, and put it behind a magnifying glass.''

Murray says he cannot begin to establish the statistical likelihood of falling victim to terrorist attacks -- there are too many unknown factors.

''I think the worst thing we can do is pretend to knowledge we don't have,'' Murray says.

It seems that ''we face far more dangerous elements in our daily life'' than terrorism, including car accidents and the flu, he says. And there are some very dangerous threats that people seem to accept without much concern.

''People live in Oklahoma, which has never been particularly clear to me, because it's Tornado Alley,'' Murray says. ''People live in flood plains and on hurricane coasts.''

That's exactly so, says Paul Slovic, president of Decision Research, a non-profit institute in Eugene, Ore., and an authority on risk perception. People tend to accept natural hazards, but they dread technological hazards.

When the Mount St. Helens erupted with the force of a nuclear bomb, ''They had to keep people away. People didn't dread the prospect that a natural nuclear bomb was about to go off -- they wanted to come and see,'' Slovic says.

But the prospect of actual nuclear accidents sets off emotional alarms.

Slovic says two processes are at work: analytical and experiential. The first uses logical assessments of risks; the second is older, primordial, employing gut feelings and memories to guide us. It would ''tell us whether this animal was safe to approach or this strange looking water was safe to drink,'' Slovic says, and it usually outpaces our intellectual reactions.

We react, he says, to two factors he calls dread risk and unknown risk.

On the top end of the dread scale are risks that are uncontrollable, fatal, catastrophic, involuntary, technological. The unknown risk scale is similar. At the top: risks that are not observable, new, unknown to those exposed, unknown to science, with delayed effects.

Slovic has created a graph, plotting 81 different hazards according to these two scales.

The lowest quadrant includes things like skateboards, swimming pools and smoking; the top quadrant -- the hazards most likely to inspire feelings of anxiety or fear, and most likely to inspire action -- include nuclear weapons fallout, reactor accidents and asbestos insulation.

Terrorism wasn't even among the hazards Slovic listed when he conducted that survey more than 20 years ago. He quotes Yale sociologist Kai Erikson: This is ''a new species of trouble.''

But he has no doubt that it would be at the very top of Slovic's risk scale -- especially anthrax, which is invisible, uncontrollable, involuntary, possibly fatal, new to most people, and has delayed effects. If you tried, you couldn't imagine a hazard more likely to inspire fear.

''And it's not just this,'' Slovic says. ''It's what's around the corner. Many people have said that the world's changed since Sept. 11. And it has, in fundamental ways.''

People have changed, too. Jennifer Lerner, a professor of social and decision sciences at Carnegie Mellon, says this may be key to how individuals assess the risks after Sept. 11.

Lerner has studied the way that emotions unleashed by events can affect the ways in which people deal with risks. A traumatic event, she says, generally inspires three reactions: anger, sadness or fear. And each one causes people to behave differently.

Angry people tend to blame individuals for what happened, Lerner says. They ''don't stop to ask themselves, 'Hmm, let me try to figure out the situation.'''

Anger is an optimistic reaction, she says -- it leads people to believe that they can take control of the situation. And it leads them to accept risks.

So far, President Bush is ''clearly taking an angry tone. And I think that's no accident,'' Lerner says. In hard times, people look to their leaders for a sense that something can be done.

Fearful people, by contrast, blame the larger situation itself. They are more pessimistic. They are less likely to accept risks, she says. Sadness falls between those two poles.

In time, people may feel all three emotions in response to an event; as they become more knowledgeable about it, they may drift from fear to anger. And some people may be more prone to one emotion or another throughout their lives.

Often, Lerner says, ''angry people fail to perceive the real risks.'' They gamble where they shouldn't, and ignore health problems. They are more prone to heart disease.

But fear has its own pitfalls.

''In general, most reactions are counterproductive in most circumstances,'' says Murray of the Statistical Assessment Service. ''Horses run back into the barn when it's burning. Why on Earth do horses do that? I guess they panic.''

Murray suggests that the impulse to hide from terrorism may be a similarly wrong response.

''American life really depends upon interchange, dynamism, openness,'' he says. ''Any hunkering down ... is most likely to amplify our risks.''

''We need to get out, to know our neighbors, to be vigilant,'' he says.

Ultimately, he predicts, we may become like the Israelis and others who live in more dangerous places. Understanding the risks, we will make them part of our routine. And then, terrorism will be like crime and fires -- real perils, but manageable.

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