Case Studies. in Radiation Risk Communication. Presented at. AIHce 2011 Portland, OR PO 119 All Things Radiation. Wednesday, May 18, 2011

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1 Case Studies in Radiation Risk Communication Presented at AIHce 2011 Portland, OR PO 119 All Things Radiation Wednesday, May 18, 2011 Ray Johnson, MS, SE, PE, FHPS, CHP VP Training Programs, 438 N. Frederick Avenue, Ste 220 Gaithersburg, MD Director, Radiation Safety Counseling Institute

2 Ray Johnson, MS, SE, PE, FHPS, CHP VP Training Programs, Director, Radiation Safety Counseling Institute Situation Problem: Cases have been evaluated at facilities using radioactive materials where workers have made statements, such as: Radiation, I don t want anything to do with that! I don t want my DNA damaged! I saw the radiation meter go off scale! Does that clicking Geiger counter mean that I will not be able to have children? We got a hot one here! I don t want to glow or have children with thee eyes! Each of these statements indicates varying degrees of fear of radiation. How would you respond to these people as an industrial hygienist? Resolution: In each case, the risk communication skills of the person responsible for radiation safety were challenged in efforts to give the most helpful responses. Hearing and responding to feelings (fears) is often difficult for technical specialists. The communication tool called Active Listening was (or could have been) very effective in each case. Active listening responds to both the content and the feeling of a communication. Results: Three of the cases were resolved by use of active listening. However, three of the cases did not use active listening and poor responses to worker fears resulted in worker and union upset, turmoil in the facility, and expensive resolutions. In one case a worked sued for damages and it cost the facility over one million dollars for legal defense. Lessons Learned: Industrial hygienists and radiation safety specialists can learn to use risk communication tools, such as active listening, to hear and respond appropriately to upset workers. Ideally use of these tools would defuse worker concerns before they get to the point of needing expensive resolutions. Hearing feelings may be more important than solving problems. Training in the use of risk communication tools could be an important asset for industrial hygienists for implementing good safety programs.

Risk Communication Situations Radiation, I don t want anything to do with that! I don t want my DNA damaged! I saw the radiation meter go off scale!

Wow, we got a hot one here! I don t want to glow or have children with three eyes 2 Wow, We Got a Hot One Here!

the was contaminated, t got her upset, slept apart for weekend Returned to work Monday after upset weekend Still did not get good answers Found a sympathetic listener, who was an attorney Filed

3 Risk Communication Situations Radiation, I don t want anything to do with that! I don t want my DNA damaged! I saw the radiation meter go off scale! Ray Johnson, MS, SE, PE, FHPS, CHP VP Training Programs Director, Radiation Safety Counseling Institute Does that clicking Geiger Counter mean that I won t be able to have children? Wow, we got a hot one here! I don t want to glow or have children with three eyes 2 Wow, We Got a Hot One Here! Statement heard by worker receiving a routine whole body scan at a nuclear plant on a Friday afternoon Concerned worker, asked questions Did not get good answers Went home, told pregnant wife that the was contaminated, t got her upset, slept apart for weekend Returned to work Monday after upset weekend Still did not get good answers Found a sympathetic listener, who was an attorney Filed lawsuit for $ 5 M damages Nuclear plant defended and won at cost over $1M What will your role be? What testimony will you be required to give? What will you say at deposition? What do you do? What issues are raised by claims? How can you prove dose? How can you prove what was said? How can you prove accuracy of instruments & records? 3 4 Will plaintiff s attorney make you look like a fool? Will you make admissions that could have devastating implications for radiation litigation for the next 50 years? How will you handle bad press of the incident and at trial? 5 6, AIHce 2011, Portland, OR May 18,

How do you defend against each of the allegations? Is it possible to defend against them? Why not just settle and avoid all the problems? Could this all have been avoided?

4 How do you defend against each of the allegations? Is it possible to defend against them? Why not just settle and avoid all the problems? Could this all have been avoided? By use of risk communication tools Such as Active Listening Plant hired a communication consultant - after the fact 7 I Saw the Radiation Meter go Off Scale! Statement of a worker at a paper making facility Meter was reading naturally occurring radium scale from use of alum for waterproofing paper Worker went on line to find answers for radiation risk Complained to union and management Got workers and management upset Management hired risk communication consultant Spent a day with worker representatives Presented series of radiation safety awareness classes Upset worker said he did not believe consultant 8 Meaning of Screaming Geiger Counter Does that mean I won t be able to have children? Should I be running? Is that x ray machine safe? Questions for Workers Is it safe to work here? What does safe mean? Who decides? How do you know? I do not answer questions of safe or unsafe Only worker s answers have any meaning Provide information to enable workers to decide Teach them how to analyze risks Steps from cause to effect 9 Tools for Evaluating Risks Steps from Cause to Effect 1. What are properties of RAM ( x ray)? form and quantity? 2. Where is it located? 3. How is it contained? 4. How will it move in the environment? 5. What are the exposure conditions? 6. How much energy is deposited in our body? 7. What doses are known to produce effects? Is it very difficult to seriously harm someone with radiation! 10 Statements of Concerned Workers Radiation, I don t want anything to do with that! I don t want my DNA damaged! Is it safe to work here? I don t want to glow or have children with three eyes What do all of these workers have in common? Are you prepared to deal with feelings and fears? Have you had training in listening skills? 11 Are You Prepared? For implementing good radiation safety? For counseling fearful or upset workers? Do you automatically think of technical issues or emotional issues? Are you stressed when dealing with emotions? Do you know how to respond to a concerned or upset worker? The most powerful tool for dealing with upset is Active Listening 12, AIHce 2011, Portland, OR May 18,

Our Greatest Challenge When the dialogue gets emotional What can we do when our best information is not accepted? How do we answer hypothetical questions? What if our answers cause more upset?

5 Our Greatest Challenge When the dialogue gets emotional What can we do when our best information is not accepted? How do we answer hypothetical questions? What if our answers cause more upset? What if we do not have any data? Is there any way to avoid emotions? 13 Active Listening Hearing and responding to feelings A skill that can be easily learned Through practice Most powerful tool for risk communication Steps for Active Listening 1. Paraphrase the content 2. Respond with a synonym that describes the feeling 3. Let the other person correct you as needed 14 Active Listening Hearing the message and the feelings Why bother? To establish rapport as basis for presenting your most helpful response To get down to the real issue of concerns for radiation risks Active listening is not easy for technical experts and managers They want to go directly to troubleshooting 15 Hearing and Reflecting Feelings Fears and upset are best handled by hearing and reflecting feelings Do not say, I know how you feel. You can never know another s feelings Describe the feeling in your words Four feelings mad, sad, glad, and afraid Let the worker correct you Dialogue process Paraphrase content and reflect the feeling Do not interpret or rationalize 16 Hearing Feelings I don t want to go in the radiation room The radiation sign makes you nervous Yes, I might still like to have children You are afraid that radiation may affect whether h you can have children Yes, I do not want children with 3 eyes So your real concern is whether radiation will affect future children Yes Ok, here is what I have learned 17 Listening is the Key Worker concerns are about images of losses or unacceptable consequences of radiation What is the basis for upset or fears? Upset fear images hurt sadness want Identifying the basis for fears and upset requires listening and asking lots of questions Rather than giving answers Questions are not to get data for giving answers Giving answers takes ownership of the problem 18, AIHce 2011, Portland, OR May 18,

6 Responding to Worker Concerns 1. Hear feelings first 1. Hearing feelings is more important than solving problems 2. Check out views and images 1. Ask lots of questions 3. Establish rapport by identifying with the perceptions Active Listening 4. Share personal experience 5. Lastly, provide factual information 1. As resource to help workers make their own decisions 19 Summary Many workers may have concerns for possible exposures to radiation Use Active Listening to hear their fears and feelings Ask lots of questions to determine the basis of their fears, not to solve their problem Provide information only as a resource Help workers find their own answers 20, AIHce 2011, Portland, OR May 18,

7 Raymond H. Johnson, MS, SE, PE, FHPS, CHP VP Training Programs, Dade Moeller & Associates Director, Radiation Safety Counseling Institute BS Civil Engineering (1961) University of Vermont MS Sanitary Engineering (1963) Massachusetts Institute of Technology (MIT) Prof. Sanitary Engineer Degree (1963) MIT and Harvard University PhD Studies, Radio and Nuclear Chemistry ( ), Rensselaer Polytechnic Inst. Greater Washington Inst. for Transactional Analysis - Counseling ( ) American Board of Health Physics Certification (1983 present) Johns Hopkins Fellow, Organizational Systems ( ) Past President and Fellow of the Health Physics Society (2000) Commissioned Stephen Minister Counselor, United Methodist Church (2003 pres) Experience 2010 pres. Director, Radiation Safety Counseling Institute, workshops, training, and counseling for individuals, companies, universities, or government agencies with concerns or questions about radiation safety pres. VP, Training Programs, Dade Moeller & Associates, training and consulting in radiation safety Director, Radiation Safety Academy. Providing x-ray and radiation safety training, audits, and consulting to industry (nuclear gauges and x-ray), universities, research facilities, and professional organizations. Specialist in helping people understand radiation, risk communication, worker counseling, psychology of radiation safety, and dealing with fears of radiation and nuclear terrorism for homeland security Manager and Contractor to National Institutes of Health (NIH) for radiation safety audits of 3,500 research laboratories and 2,500 instrument calibrations a year, along with environmental monitoring, hot lab and analytic lab operations, and accelerators and x-ray inspections President of Key Technology, Inc. a manufacturer and primary laboratory for radon analysis with over 1,500,000 measurements since Primary instructor at Rutgers University for radon, radon measurements, radiation risks, radiation instruments, and radon risk communication courses Laboratory Director, RSO, Inc. Directed analytical programs and Quality Assurance for samples from NIH, Aberdeen Proving Ground, radiopharmaceutical companies, and the nuclear industry Chief, Radiation Surveillance Branch, EPA, Office of Radiation Programs. Directed studies of radiological quality of US, coordinated 7 Federal agencies for nuclear fallout events, QA officer 8 years. Head of US delegations to I.A.E.A and N.E.A. on radioactive waste disposal. ANSI N-13, ( ). Retired PHS Commissioned Officer (0-6) in 1985 with 29 years of service U.S.P.H.S. Directed development of radiation monitoring techniques at DOE National Labs, nuclear plants, and shipyards in the US and Chalk River Nuclear Laboratory in Canada. Health Physics and Professional Activities Health Physics Society (HPS) plenary member 1966; President-elect, President, Past President ( ), Fellow (2000), Treasurer ( ); Secretary ( ); Executive Cmte. ( ), Chair, Finance Cmte. ( ); Head of U.S. delegation to IRPA X (2000). RSO Section Founder and Secretary/Treasurer ( ); Co-founder and President, Radon Section ( ). Co-Chair Local Arrangements Cmte. Annual Meeting in DC (1991); Public Info. Cmte. ( ); Summer School Co-Chair (2004); Chair, President s Emeritus, Cmte (2006); Chair, Awards Cmte. (2002); Chair, History Cmte. (2005-Pres.); Continuing Education Cmte. (2005-Pres,). Treasurer, AAHP (2008 Pres.). Academic Dean for HPS Professional Development School on Radiation Risk Communication (2010). PEP, CEL and AAHP Instructor; Journal Reviewer; Baltimore-Washington Chapter: President ( ) and Honorary Life Member; Newsletter Editor ( ); Public Info. Chair ( ), Science Teacher Workshop Leader (1995 Pres.). New England Chapter: Newsletter Editor, Board of Directors, Education Chair ( ). President, American Association of Radon Scientists and Technologists ( ) and Honorary Life Member, Charter Member; Board of Directors; Newsletter Editor ( ). Founder and first President, National Radon Safety Board (NRSB) ( ). Member of Sigma Xi (1966-Pres.); ANS (1983-Pres.), Society for Risk Analysis (1984-Pres.); AIHA, CRPA, CRCPD (1997-Pres.), Studied H.P. communication styles and presented Myers-Briggs seminars to over 3500 H.P.s since Over 30 professional society awards. Registered Professional Engineer since Certified Health Physicist since Publications Authored over 500 book chapters, articles, professional papers, training manuals, technical reports, and presentations on radiation safety. Author of monthly column, Insights in Communication HPS Newsletter and Contact at: , ray.johnson@moellerinc.com; ,

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