such as MeHg and EPA/DHA impacts on neurologic development, it is not necessary to artificially link the benefit and risk through a separate construct such as QALYs.
In light of uncertainty in the scientific information associated with both nutrient intake and contaminant exposure from seafood, it is the committee’s judgment that no summary metric adequately captures the complexity of seafood benefit-risk trade-offs. The committee outlined an approach to balance benefits against risks, conducted an analysis of the trade-offs, and considered additional factors that informed each in order to produce a decision framework that incorporates benefit and risk analysis. Over time, the process of balancing benefits and risks must be iterative, with systematic, objective reviews following strict profiles, and updates and reinterpretation as new evidence is developed. This can be accomplished through the convening of an expert group such as this committee or through the organization of expertise within federal agencies to provide comprehensive benefit-risk analysis rather than piecemeal benefit-by-benefit and risk-by-risk analysis.
In developing its approach to balancing benefits and risks, the committee considered previous approaches developed to analyze scientific evidence and balance benefits and risks: two of these approaches are risk-risk or risk-trade-off analysis and risk relationship analysis.
“Risk-risk” or “risk-trade-off” analysis was developed as a means of further evaluating regulatory and other actions targeted at reducing a specific risk (Gray and Hammitt, 2000; Hammitt, 2000; IOM, 2003). This approach emphasizes that in reducing a targeted risk, it is possible that other risks would be created or increased. This approach also provides a means for considering multiple countervailing risks that may indicate whether it is either riskier to remediate a problem or take no action.
“Risk-relationship” analysis goes a step further, recognizing the possible existence of ancillary benefits as well as countervailing risks that may result from adopting a particular risk-management option (IOM, 2003). For example, efforts to reduce a contaminant in a specific food product may pose a countervailing risk if the efforts make a nutrient-rich food too expensive for some consumers to afford. In addition, the higher price of the product could cause consumers to switch to alternative products that pose similar or higher risk from the same or other contaminants. However, if the product is high in a food component that is unhealthful, then a switch away from it may generate ancillary benefits such as reduced risk for chronic disease.
The committee concluded that its charge goes an important additional step beyond risk-relationship analysis. Risk-relationship analysis starts with a targeted risk reduction and attempts to identify significant potential