The Duke of Hazard
words by Barbara Hurley / photograph by John Emerson
Adam Finkel,
SCD, MPP, CIH
professor of
environmental and occupational health at UMDNJ-School of Public Health
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et’s say you’re one of a thousand people who live near or work at a paper mill. In order to produce paper, there will be emissions from the plant. These need to be controlled to reduce the risk of cancer to those exposed. Still, some may get cancer who otherwise wouldn’t have. What are your chances of getting cancer? What’s an acceptable additional risk? Who decides?
Risk assessment — the study of the probability and magnitude of harm — quantifies the problem and helps society think about what is an “acceptable” level of risk, explains Adam M. Finkel, professor of environmental and occupational health at UMDNJ-School of Public Health and a nationally recognized expert in the field. But he emphatically adds that even a small risk can be unacceptable if a cost-effective way to minimize it exists.
Sometimes society makes contrary decisions about risk assessment, Finkel says. Our automobiles now have seat belts and air bags, and although we know that reducing the highway speed limit to, say, 40 miles per hour would reduce the number of deaths by auto, we know that most people would not comply. And so the risk at a higher speed limit is considered acceptable.
Finkel’s path to risk assessment expertise began as a 16-year-old undergrad at Harvard, where he earned a degree in biology cum laude. Intrigued by the relationship between science and politics, he received a Master of Public Policy from the Kennedy School of Government and then a Doctor of Science in environmental health sciences from the School of Public Health, both at Harvard.
He can also lay claim to a “very small” part of a recent Nobel Prize – the first in which risk assessment was involved. In the summer of 1983, while a Kennedy School student, Finkel was a congressional intern on the Investigations and Oversight Subcommittee of the House Science and Technology Committee. Representative Albert Gore, Jr. was chairman. Twenty-four years later, coincidentally, the two men would both participate in the Nobel Peace Prize. Al Gore shared the prize with the Intergovernmental Panel on Climate Change, which was cited for an award-winning series of reports it had published. As it happened, Finkel was a contributing author to the chapter assessing key vulnerabilities and risk from climate change in the most recent report.
Finkel describes his career as “science advocacy.” He sees basic science as focusing on understanding, and science advocacy as focusing on applying that understanding to problem solving. Now he is adamant about the need to make risk assessment more useful and productive. “We’ve gotten good at dissecting problems,” he notes, “but not at finding solutions to larger issues. We need to view the larger picture. Otherwise we can solve one problem at the expense of another.” Remember the paper mill? Finkel points out, by way of example, that the EPA might put controls in place to reduce pollution entering the environment, but this could lead to a concentration of pollution inside the plant, putting the workers at greater risk of harm.
Finkel himself is no stranger to professional risks. He acknowledges that of all he has accomplished in his field, he has received most attention for his whistleblower dispute with the U.S. Occupational Safety and Health Administration (OSHA). He joined OSHA in 1995 in Washington, DC. Admittedly stubborn, he found himself disappointed in the Agency’s energy level and sense of priorities, and was sent to Denver as Rocky Mountain Regional Administrator because of “a difference of opinions with the powers that be” over the details of OSHA’s proposed regulation to control ergonomic hazards.
The story and its culmination say a great deal about the man. While working in DC within the regulatory sphere, Finkel had noticed that the existing limits for beryllium exposure were nearly 60 years out of date and that there was little agency interest in revising them. By 2001, he became aware that many OSHA inspectors had been exposed to high levels of this toxic metal, which can cause an often-fatal lung disease. He became an official whistleblower when he went public with his findings after a senior Department of Labor official refused to inform the inspectors of their risk or provide medical testing to detect early signs of the disease. He was removed as regional director and called back to Washington, but the publication of his findings led to a medical monitoring program for OSHA inspectors, which revealed an unexpectedly high incidence of health effects from beryllium exposure.
Despite the way his time at OSHA concluded, he is particularly proud of the role he played while at OSHA in devising regulations to prevent needlesticks among healthcare workers and to reduce exposures to methylene chloride, which, he notes, “means fewer people who have worked in the furniture and related industries will develop cancer 30 years from now.”
For the last two years, Finkel has been working to get OSHA to release its data on workplace exposures and the specific test results of the beryllium screening program. He plans to do research on the results, which were just made available under a successful lawsuit he filed under the Freedom of Information Act after efforts that he described as “needlessly time consuming and expensive for the taxpayers.” Among other projects, Finkel intends to explore whether controls to comply with environmental regulations have tended to increase worker exposures to toxic substances.
It was in fact the whistleblower settlement with OSHA that made an academic appointment desirable and brought Finkel to UMDNJ in 2004. After leaving the agency he wanted to find one place for both his public health and public policy interests. He came close with his move to New Jersey and the School of Public Health position, combined with a visiting professorship at Princeton’s Woodrow Wilson School. Now he splits his time between UMDNJ and the University of Pennsylvania, where he is the first executive director of the Penn Program on Regulation and a fellow at the Penn Law School. The move also brought him closer to his Philadelphia roots.
Finkel has paid a personal price for his commitment to science-based advocacy — little time for his other passion, singing and conducting choral music. He loves opera and early sacred music. And apparently lullabies. He created a private-issue CD — Golden Slumbers — for the birth of his daughter, Maia, who is now 7. He also realizes that his battle with OSHA was a particular hardship for his wife, Joanne, a clinical psychologist whose private practice moved with each of his assignments.
Now settled at UMDNJ, Finkel hopes to establish a “Center for Risk-Informed Solutions” at the School of Public Health. “Many such academic centers have come and gone,” he reports, “basically because of funding issues.” Much of the funding for these institutes has come from corporate sources, which, right or wrong, casts the “pall of skepticism” over research and results. He is looking to establish a balanced portfolio of funding from government, private foundations, and industry to support a UMDNJ institute.
Each spring, Finkel teaches a course on risk assessment that some of his students described as “one of the toughest courses at the school.” Chalk this reputation up to his determination to teach where concepts come from, rather than just how to apply them. He wants his students to see the flaws in risk assessment and correct them, not just “follow the cookbook.” To him, assessing risk is a way to help make choices, but he believes that making good decisions is not an innate talent but a skill that can be honed. One of his favorite quotes is from the wizard Dumbledore in the Harry Potter series: “It is not our abilities that show what we truly are — it is our choices.” Finkel’s goal is to equip his students to make and evaluate choices in their own lives, “even if they never do another environmental health risk assessment.”
His work in and out of the classroom has led to professional recognition. In 2006, Finkel received the prestigious David P. Rall Award for Advocacy in Public Health, an honor named for the “intellectual and ethical founder of modern environmental medicine.” When receiving the award from the American Public Health Association, Finkel summed up his career in science advocacy quite eloquently: “I am drawn to try and take the least circuitous path to the truth. So far, it has been easy, in that my tendency towards precautionary analysis and my concern for workers have never come into conflict with what I see as true.”
And truth be told, Finkel’s career is a powerful parable for his students about the intellectual satisfaction of analyzing risk and how people look at it and the personal satisfaction of knowing that, above all, he is in the business of protecting human health.