Case study: The downside of using a worst-case approach in occupational safety policy as an interpretation of the precautionary principle: Putting the uncertain UXO occupational safety risk into probabilistic perspective.

Unexploded ordnance (UXO) from the World Wars on the North Sea floor pose an uncertain occupational safety risk for dredging and cable installation. At present mitigation strategies are based on an interpretation of the precautionary principle that uses a worst-case approach, that is, assuming that UXO will be encountered, will explode, and will harm people onboard. We propose a probabilistic framework to estimate the UXO risk.

[Risk management with regard to QT-prolonging drugs].

Drug-induced QT prolongation increases the risk of Torsade de Pointes (TdP). Drug-induced QT prolongation is a complex and unpredictable system due to many uncertainties. Risk factors such as electrolyte disturbances, heart failure and genetics play an important role in estimating the effect on QT prolongation.

[Medication verification in hospital: is it proportional?].

In 2008 in the Netherlands the Guideline 'Transmission of medication in the chain' was published. This guideline described that upon admission and discharge in the hospital verification of medication should take place. This caused significant investments in staff by hospitals to meet with this guideline.

Building Blocks Towards a Proportionate Chemicals Policy With a Focus on the Netherlands.

In this contribution, we propose that 'sound' government policy should be characterised by a proportionate, integral vision with due consideration to tradeoffs between social costs and benefits. This principle also applies to government policy regarding the protection of workers from exposure to chemicals. It should be taken into account that having a job is a huge health benefit.

[Black particles in plasma and carcinogenic pills].

Recently in a national newspaper presumed large hazards in care were described. Visible black particles were seen in blood plasma and a cancerogenic substance was found in paracetamol. Every year 300.

Organisational resilience: Shifting from planning-driven business continuity management to anticipated improvisation.

As unpredictable major-impact events are on the rise, many organisations have adopted an organisational resilience (OR) approach for dealing with these so-called 'black swan events. What OR comprises is subject to ambiguity and multiple interpretations. This article presents a perspective that makes a distinction between predictable risks and unpredictable major-impact events.

Integrated modelling of medical emergency response process for improved coordination and decision support.

The medical emergency response comprises a domain with complex processes, encompassing multiple heterogeneous entities, from organisations involved in the response to human actors to key information sources. Due to the heterogeneity of the entities and the complexity of the domain, it is important to fully understand the individual processes in which the components are involved and their inter-operations, before attempting to design any technological tool for coordination and decision support. This work starts with the gluing together and visualisation of the interactions of involved entities into a conceptual model, along the identified five workspaces of emergency response.

Decision-making and evacuation planning for flood risk management in the Netherlands.

A traditional view of decision-making for evacuation planning is that, given an uncertain threat, there is a deterministic way of defining the best decision. In other words, there is a linear relation between threat, decision, and execution consequences. Alternatives and the impact of uncertainties are not taken into account.

EvacuAid: a probabilistic model to determine the expected loss of life for different mass evacuation strategies during flood threats.

Evacuation of people in case of a threat is a possible risk management strategy. Evacuation has the potential to save lives, but it can be costly with respect to time, money, and credibility. The consequences of an evacuation strategy depend on a combination of the time available, citizen response, authority response, and capacity of the infrastructure.

Time needed to evacuate the Netherlands in the event of large-scale flooding: strategies and consequences.

On 30 May 2008, the Government of the Netherlands informed the national parliament about the effectiveness of preventive evacuation of coastal and river areas in case of flooding. Analysis of a case study showed that it is impossible to evacuate coastal areas preventively within a 48-hour time span preceding a worst credible scenario flood caused by a storm surge. This fact illustrates the need for alternative evacuation strategies, such as vertical evacuation (evacuating to safe havens, inside the flood zone) or shelter-in-place (hiding), to reduce loss of life and the impact of the evacuation.

Naturalistic decision making in forensic science: toward a better understanding of decision making by forensic team leaders.

This study uses the naturalistic decision-making (NDM) perspective to examine how Dutch forensic team leaders (i.e., the officers in charge of criminal forensic research from the crime scene until the use of laboratory assistance) make decisions in real-life settings and identifies the contextual factors that might influence those decisions.

How prepared is prepared enough?

Decisions about disaster preparedness are rarely informed by cost-benefit analyses. This paper presents an economic model to address the thorny question, 'how prepared is prepared enough?' Difficulties related to the use of cost-benefit analysis in the field of disaster management concern the tension between the large number of high-probability events that can be handled by a single emergency response unit and the small number of low-probability events that must be handled by a large number of them. A further special feature of disaster management concerns the opportunity for cooperation between different emergency response units.

Prioritizing care during the acute phase: the prominent role of basic psychosocial life support.

The issue of basic psychosocial life support during and after disasters is important. People who are affected by disasters can experience severe distress and may need psychosocial support. However, there still are many questions about service design and effectiveness of psychosocial support.