Multiple sources of uncertainty exist in any risk assessment including those conducted by the U.S. Environmental Protection Agency (EPA), the lead agency responsible for protecting Americans against significant risks to human health and the environment. The EPA asked the Institute of Medicine (IOM) to convene a committee to provide guidance for its decision makers and partners on approaches to manage risk in different contexts when uncertainty is present. To tackle this issue, the IOM assembled a committee of experts in the fields of risk assessment, public health, health economics, decision analysis, public policy, risk communication, and environmental and public health law. The committee met five times, including three open sessions during which committee members discussed relevant issues with outside experts and discussed the charge with the EPA.

In discussing its charge, the committee found it helpful to clarify the questions in its statement of task. When considering that question of “how … uncertainty influence[s] risk management under different public health policy scenarios,” the committee deliberated on how uncertainty can and should influence decisions and help decision makers, rather than focusing on how it currently influences such decisions. In addition, when considering tools and techniques from other areas of public health policy, the committee considered whether there are tools and techniques available from other decision-making settings of potential use to EPA decision making, what their benefits and drawbacks are, and whether and how those tools could be applied by EPA.

Uncertainty is a very broad topic with many potential implications for decision making; this presented a thorny challenge to the committee throughout its deliberations. That challenge was amplified by the broad range of

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