Specific Risk Assessment Research Articles

Genomics and breast cancer screening.

Many women fear the risk of developing breast cancer, and some women have increased fear because of their family history. Thankfully, the study of genetics has brought forth tools to better identify women at risk. An understanding of genetics and cancer has led to genetic testing protocols which enable at-risk women to take preventative action through medication, surgery, and intensive screenings. These protocols not only have the potential to prevent cancer but also lead to early detection. Appropriate screening for women at risk for genetic breast cancer is essential for patient care. These screenings include specific risk assessment tests, genetic counseling, and genetic testing. To provide the best possible care for patients, providers must have a basic understanding of cancer, genetics, screening tests, genetic testing, and available prevention measures.

Preoperative risk stratification of patient mortality following elective craniotomy; a comparative analysis of prediction algorithms

Factors associated with mortality following craniotomy for non-traumatic etiologies are not well studied. We performed a retrospective case-control study to investigate the utility of the Gupta, RCRI, KPS, ASA, and NSQIP risk calculators in predicting complication and mortality rates among a neurosurgical patient population undergoing elective craniotomy and used ROC curves to determine their relative predictive accuracy. We identified 17 patients who died following elective craniotomy and 17 control patients who survived, matched for sex, age, comorbid conditions, and intervention. The deceased cohort experienced a greater degree of surgical complications, with concordantly higher preoperative risk scores as assessed by Gupta, KPS, ASA, and NSQIP scales. Cause of death was secondary to a surgical complication in 11 (65%) cases and nonsurgical in 6 (35%) cases. When comparing our deceased and survival cohorts for specific complication profiles, higher RCRI score was significantly associated with postoperative cardiac death. Poor preoperative ASA and KPS score were both associated with mortality. NSQIP risk was significantly associated with mortality and nonsurgical and cardiopulmonary complications. ROC analyses comparing predictive scales found no clearly superior prediction algorithm for postoperative complications or mortality; NSQIP and RCRI were highly predictive of cardiac death, KPS and NSQIP with nonsurgical complications, and Gupta, ASA, KPS, and NSQIP with postoperative mortality. NSQIP scores correlated most broadly with nonsurgical complications and mortality. Future efforts at quality improvement in healthcare value will be rooted in the development of more accurate and specific risk assessment strategies specific to neurosurgery.

Consumer protection and risk assessment: sensitising substances in consumer products

The human immune system is confronted daily with a large, chemically-varied range of potentially sensitising substances. Skin sensitising substances are found, above all, in a plethora of consumer products, e. g. cosmetics, jewellery, earrings, toys, textiles, leather, other everyday commodities and, in some cases, also tattoos. These products may contain sensitisers such as fragrances, preservatives, dyes, or other additives. To provide a greater degree of consumer protection, there is a need for specific legal regulation and risk assessment, which covers each possible human exposure to a sensitising substance or mixture. This review article describes the background and pathway towards the development and implementation of an international legal framework for the classification and labelling of chemicals that contain potentially skin sensitising substances. This includes the implementation of the globally harmonized system of classification and labelling of chemicals (GHS), the classification, labelling and packaging (CLP) regulation, registration, evaluation, authorisation and restriction of chemicals (REACH), and the regulation of cosmetics, among other national laws and regulations. Assessment criteria for classification is derived from a suite of in vitro and in vivo assays, in addition to in silico approaches—validated by the organisation for economic cooperation and development (OECD)—as well as data derived from human studies. New legislation for chemical and product safety is reflected in the classification and labelling of skin sensitising substances under Category 1, Subcategory 1A or 1B, within which the threshold concentrations of several materials are regulated, e. g. p‑phenylenediamine in hair dyes, nickel in piercings, chromium VI in leather and methylisothizolinone in cosmetics. In order to minimise the risk of human contact allergy from consumer products, the scientific committee on consumer safety (SCCS) and the German federal institute for risk assessment (BfR) investigate pathways of exposure and perform risk assessments using new in vitro approaches and new (immuno-) toxicological concepts (i. e. adverse outcome pathways [AOPs], key events as well as an integrated approach to testing and assessment [IATA]). In comparison to cosmetics, substances in textiles and other consumer products are less regulated. Major efforts in research and development are necessary to decode complex substance-specific molecular mechanisms in allergic responses and to define new substance-specific thresholds. Such efforts have been continuously proposed by the BfR with regard to fragrances for over 10 years. Today, skin sensitising substances can be legally regulated and labelled and, depending on the exposure, their content in consumer products can be reduced or eliminated. Furthermore, the risk assessment of potentially sensitising substances makes consumer products safer. Further improvements in research approaches are required in the area of health and consumer protection with regard to allergy.

Toxicity to residual chlorine: Comparison of sensitivity of native Arabian Gulf species and non-native species

Chlorine is extensively used as a powerful oxidizing agent in the countries surrounding the Arabian Gulf for water treatment and biofouling control. Its usage has been increasing significantly as demand for water grows considerably both in industry and for domestic use. This is due to the fact that it is a well-tested technology, has had a history of long-term worldwide industrial use and is of acceptable cost. While the Arabian Gulf waters support a range of coastal and pelagic marine habitats including mangrove forests, seagrass meadows and coral reefs, marine organisms in these waters are living close to their tolerance limits due to the extreme environmental stressors like temperature and salinity. Anthropogenic stressors such as chlorine may further exacerbate these natural stressors. In seawater, chlorine produces a mixture of hypochlorous acid and hypochlorite ion. These rapidly react with the bromide ion to form a mixture of hypobromous and hypobromite ion. Total residual oxidants formed by chlorination although are short lived and not persistent in seawater, they can be quite toxic. In the present study, toxicity data were obtained from 7 acute toxicity tests and 3 chronic toxicity tests using Arabian Gulf aquatic species from different trophic levels. The study also examined the effect of temperature and developmental stages on toxicity of chlorine. Furthermore, differences in the species sensitivity distribution between native and non-native species were compared. The main finding of the study showed that there was no significant difference between native and non-native species for chlorine toxicity. This would suggest that toxicity data from different geographic region can be used in deriving site- specific ecological risk assessment of chlorine. Keywords: Chlorine; Arabian Gulf; acute toxicity; chronic toxicity; risk assessment; species sensitivity distribution;

PREOPERATIVE MANAGEMENT OF PATIENTS WITH CARDIOVASCULAR DISEASES FOR ELECTIVE CANCER SURGERY

Significant progress in the diagnosis and treatment of cancer resulted in a marked improvement in the survival of these patients. Declining mortality in acute cardiovascular diseases is accompanied by an increase in the proportion of patients with chronic cardiovascular pathology. Both trends resulted in a growing cohort of patients with concomitant oncology and cardiovascular disease, given rise to cardiooncology, a rapidly growing field. Cardio-oncology incudes a variety of clinical issues, particularly preoperative assessment of patients for cancer surgery. However, this section has been recently neglected in the recent guidelines. This review focuses on the preoperative management of patients with cardiovascular diseases for elective cancer surgeries. It reports the existing algorithm of assessing the risk of cardiac events in non-cardiac surgeries relatively to cancer patients. Current international and national guidelines were published in 2014 and, therefore, do not contain the latest evidences. Thus, this review summarizes all recent data and provides a modified and simplified preoperative management strategy for cancer patients. In particular, surgical risk assessment should be comprehensive, taking into account the complexity of the surgical procedures and the severity of comorbidity. The review discusses specific risk assessment scales proposed for different groups of cancer patients (for example, the ThRCRI scale in surgeries for non-small cell lung cancer). In addition, it contains various options for assessing the functional status of patients (stress tests, including spiroergometry, DASI index, assessment tables). Current recommendations on additional screening and preventive treatment of patients are summarized and addressed to the healthcare specialists and researchers studying perioperative risk assessment in cancer surgery.

The effect of integrated reporting on integrated thinking between risk, opportunity and strategy and the disclosure of risks and opportunities

Integrated reporting requires a new form of disclosure to provide a holistic view of the organisation and aims to support integrated thinking, decision-making and actions that focus on the creation of value. The International Integrated Reporting <IR> Framework (IIRC 2013b) provides guidelines for the content elements required in an integrated report. One of the content elements is ‘risks and opportunities’. This study firstly assessed whether integrated reporting has enhanced integrated thinking between strategy and the risks and opportunities faced by the organisation. For this purpose, a web-based research questionnaire was sent to high-level implementers of integrated reporting at companies listed on the Johannesburg Stock Exchange (JSE) in South Africa, where integrated reporting is a listing requirement. The results of the study provide new insights for companies preparing integrated reports, as well as other stakeholders, which show that integrated reporting has driven change towards integrated thinking between strategy, risks and opportunities. Secondly, a content analysis was done on a sample derived from the top 100 companies listed on the JSE to determine whether integrated reporting has brought about a change in the disclosure of risks and opportunities. The results provide new research findings and indicate that most companies conform to the disclosure requirements noted in the International <IR> Framework (IIRC 2013b) regarding risks and opportunities except for disclosures relating to the assessment of specific risks. The content analysis further found that integrated reporting has driven limited change in the disclosure of risks and opportunities.

CONCEPT OF TECHNOGENIC RISK MANAGEMENT

There are proposed conceptual positions and levels of decision-making on provision of the safety, social and medical protection of the human on the base of the assessment, analysis and risk management in different areas of human activity in normal and emergency conditions under the exposure to man-made and some natural hazard sources. At the base of developed applications there is a unified approach to the development and use of modern risk assessment methodology: the elaboration of a common method of the risk assessment and, basing on it, specific and simplified methods for concrete sources of hazard impact. This structure of methodological bases of risk assessment, in its full development makes it more transparent and comparable as well specific methods, as the support of decision-making on protective and other measures from different sources of danger. There were formulated proposals for universal safety standards (SSs) and other levels of decision-making on safety, social and medical protection of the population and staff of hazardous industries, including acceptable levels of risk. For the establishment of SSs and other decision-making levels, a special risk index is used: the relative damage (ratio of years of life lost to a year of stay-at-risk). This index is most appropriate for evaluation, comparison and management of risk, especially in conditions of two or more acting danger sources. On the base of universal SSs there are developed branch main SSs for certain isolated sources of danger. They are expressed in those indices (specific risk indices or impact indices in their different definitions), which by now are widely used in the practice or will be chosen for practical use in the future. In the ensuring human safety in normal conditions, the main use of the risk assessment is the development and support of SSs and other levels of decision-making. In emergencies the specific risk assessment besides to the establishment the decision-making levels is essentially needed to make justified optimal decisions on the measures of social and medical protection of the population and professionals.

Pressure injury risk assessment and prevention strategies in operating room patients – findings from a study tour of novel practices in American hospitals

Hospital-acquired pressure injuries (HAPI) lead to complications such as increased pain, increased bed days, re-admissions, multiple surgical interventions, possible disfigurement, decreased quality of life, increased healthcare cost and mortality. There are several factors specific to the operating room suite which increase the risk of pressure injury development. Highlighting the need for OR specific pressure injury risk assessment tools. Research indicates that pressure injuries occurring in the OR can appear up to 48-72 hours post-surgery, thus the incidence of pressure injury originating in the OR is likely to be higher than is currently reported. Facilities in the USA are now attributing pressure injuries that appear 72 hours post-surgery to the care the patient received in the ORS.A study tour to the United States of America in 2017 discovered there are two pressure injury risk assessment tools for the operating room patient and numerous prevention strategies to minimise the risk of pressure injuries developing in the OR.

Perspectives of Optimization of Technical Services and Maintenances Using Risk-Informed Decision-Making at NPPs in Ukraine

In most cases, when it goes about maintenance and repair optimization, the repair concept based on technical state of equipment is considered. This article describes the approach to maintenance and repair optimization at nuclear power plants by their transfer from the outage period to unit operation at power. The analysis of maintenance and repair optimization at foreign NPPs is carried out. The U.S. experience in reducing the outage duration is described. The article presents information on the pilot maintenance and repair optimization project at Zaporizhzhya NPP unit 2. The US Department of Energy through Argonne National Laboratory provides support in the implementation of the project in Ukraine focused on maintenance optimization of safety important systems based on risk-informed configuration management. The scope of this Project involves technical engineering analyses, plant personnel training, a study of improved economic performance indicators, and development of new strategies for NPP configuration, maintenance and operation. In order to optimize plant oeration, it is necessary to analyze plant commitments and requirements using effective, unbiased engineering assessments. Plant specific Probabilistic Risk Assessment combined with other engineering analyses techniques will be used for these assessments. This article also describes the results of the analysis of the preparedness of the Ukrainian regulatory framework for the implementation of the Project on maintenance optimization. The analysis focused on the U.S. and Ukrainian regulations and documents of the IAEA and WENRA international organizations related to maintenance optimization using riskinformed management of plant configuration. Based on the comparative analysis results, the authors identified possible limitations stipulated by non-compliance of the Ukrainian nuclear and radiation safety regulatory framework with the U.S. regulatory and methodological documents used for maintenance and repair optimization at the U.S. NPPs. In particular, the overview of USA regulations leads to the conclusion that they contain exhaustive requirements for the application of maintenance using risk-informed plant configuration management at all stages of its implementation, starting with the requirements for the alternative approach to maintenance and ending with the requirements for maintenance performance monitoring. Ukrainian regulations in turn contain only general provisions and areas for potential application of risk-informed approaches in operation and inspection. It should also be noted that the U.S. maintenance optimization methodology uses criteria based on the core damage frequency and large early release frequency. However, besides core damage frequency Ukraine uses the emergency release frequency criterion that does not correspond to the definition for large early release frequency used in the U.S.

Source specific exposure and risk assessment for indoor aerosols

Poor air quality is a leading contributor to the global disease burden and total number of deaths worldwide. Humans spend most of their time in built environments where the majority of the inhalation exposure occurs. Indoor Air Quality (IAQ) is challenged by outdoor air pollution entering indoors through ventilation and infiltration and by indoor emission sources. The aim of this study was to understand the current knowledge level and gaps regarding effective approaches to improve IAQ. Emission regulations currently focus on outdoor emissions, whereas quantitative understanding of emissions from indoor sources is generally lacking. Therefore, specific indoor sources need to be identified, characterized, and quantified according to their environmental and human health impact. The emission sources should be stored in terms of relevant metrics and statistics in an easily accessible format that is applicable for source specific exposure assessment by using mathematical mass balance modelings. This forms a foundation for comprehensive risk assessment and efficient interventions. For such a general exposure assessment model we need 1) systematic methods for indoor aerosol emission source assessment, 2) source emission documentation in terms of relevant a) aerosol metrics and b) biological metrics, 3) default model parameterization for predictive exposure modeling, 4) other needs related to aerosol characterization techniques and modeling methods. Such a general exposure assessment model can be applicable for private, public, and occupational indoor exposure assessment, making it a valuable tool for public health professionals, product safety designers, industrial hygienists, building scientists, and environmental consultants working in the field of IAQ and health.

Development of a bariatric surgery specific risk assessment tool for perioperative myocardial infarction

BackgroundPerioperative myocardial infarction (PMI) is a feared complication after surgery. Bariatric surgery, due to its intraabdominal nature, is traditionally considered an intermediate risk procedure. However, there are limited data on MI rates and its predictors in patients undergoing bariatric surgery. ObjectivesTo enumerate the prevalence of PMI after bariatric surgery and develop a risk assessment tool. SettingBariatric surgery centers, United States. MethodsPatients undergoing bariatric surgery were identified from the MBSAQIP participant use file (PUF) 2016. Preoperative characteristics, which correlated with PMI were identified by multivariable regression analysis. PUF 2015 was used to validate the scoring tool developed from PUF 2016. ResultsWe identified 172,017 patients from PUF 2016. Event rate for MI within 30 days of the operation was .03%; with a mortality rate of 17.3% in patients with a PMI. Four variables correlated with PMI on regression, including history of a previous MI (odds ratio [OR] = 8.57, confidence interval [CI] = 3.4–21.0), preoperative renal insufficiency (OR = 3.83, CI = 1.2–11.4), hyperlipidemia (OR = 2.60, CI = 1.3–5.1), and age >50 (OR = 2.15, CI = 1.1–4.2). Each predicting variable was assigned a score and event rate for MI was assessed with increasing risk score in PUF 2015; the rate increased from 9.5 per 100,000 operations with a score of 0 to 3.2 per 100 with a score of 5. ConclusionThe prevalence of MI after bariatric surgery is lower than other intraabdominal surgeries. However, mortality with PMI is high. This scoring tool can be used by bariatric surgeons to identify patients who will benefit from focused perioperative cardiac workup.

Wandering behaviour and elopement in the nursing home

People living with dementia are at risk of harm due to a decline in their cognition. This decline can cause wandering or persistent walking, which is stressful for both the person with dementia and their carer. Wandering can lead to falls and other injuries, elopement, getting lost and even death. People with dementia who wander are often admitted to long-term care facilities for safety reasons and because their carers cannot cope. Specific strategies, policies, risk assessment and management procedures are needed for these residents. This article explores the challenges encountered and provides solutions for care staff to better manage wandering behaviour in residents in long-term care settings.

Položaj i tretman osuđenih sa mentalnim poremećajima u penalnom sistemu

Persons with mental illnesses may be deprived of their freedom should they be associated with committing crime. Te rate of convicts with mental disorders in prisons ranges between 15% and 25%. Their detention negatively affects their mental health, increases recidivism risks and reduces the possibility of rehabilitation. Penal treatments practiced in the world are focused on their criminogenic needs, whilst in Serbia, despite the existence of official instruments for assessing convicts' risks, needs and capacity for change, there have not been any research studies on application of effective treatments in penal institutions for convicts with mental disorders. Te aim of the paper was to demonstrate the presence frequency of mentally ill convicts in penal system, the specificity of the status of simultaneously ill and incarcerated persons, the normative rules which determine their sanctions, specific recidivism risk assessment instruments and specialized effective treatments in foreign penal systems of this dually stigmatized population.

Pragmatic Development of an Evidence-based ICU Specific Falls Risk Assessment Tool: The Tyndall Bailey Falls Risk Assessment Tool (TBFRAT)

Pragmatic Development of an Evidence-based ICU Specific Falls Risk Assessment Tool: The Tyndall Bailey Falls Risk Assessment Tool (TBFRAT)

BIOLOGICAL EFFECTIVENESS OF LOWER-ENERGY PHOTONS FOR CANCER RISK.

For risk assessment of photon exposures, the energy-dependence of relative effectiveness may be required. The NCRP has recently addressed this need by reviewing the available evidence from various fields of study and making recommendations for the effectiveness ratio of lower-energy photons, for the purposes of quantitative uncertainty analysis for specific cancer risk assessments where lower-energy photons and electrons are involved. The present paper provides a personal discussion of selected aspects of the evidence and analysis; it highlights the key role of low-energy electrons in determining biological effectiveness.

Development of a New Sequential Extraction Procedure of Nickel Species on Workplace Airborne Particulate Matter: Assessing the Occupational Exposure to Carcinogenic Metal Species.

Nickel (Ni) compounds and metallic Ni have many industrial and commercial applications, including their use in the manufacturing of stainless steel. Due to the specific toxicological properties of the different Ni species, there is a growing interest about the availability of analytical methods that allow specific risk assessment, particularly related to exposure to the Ni species classified as carcinogenic. In this paper, we described a speciation method of inorganic Ni compounds in airborne particulate matter, based on selective sequential extractions. The analytical method described in this paper allows the determination of soluble, sulfidic, metallic, and oxide Ni by a simple sequential extraction procedure and determination by Atomic Absorption Spectroscopy using small volumes of solutions and without long evaporation phases. The method has been initially set up on standard laboratory mixtures of known concentrations of different Ni salts. Then it has then been tested on airborne particulate matter (powder and filters) collected in different workstations of a large stainless steel production facility. The method has occurred effectively in the comparison of the obtained results with occupational exposure limit values set by the main international scientific and regulatory agencies for occupational safety and health, in order to prevent both toxic and carcinogenic effects in humans.

Estimating the Burden of Hospital-Acquired Venous Thromboembolism: The Argument for Implementation of Mandatory Risk Reduction Strategies

IntroductionVenous thromboembolism (VTE) remains a major contributor to global disease burden and is a leading cause of cardiovascular death worldwide. Hospital-acquired VTE (HA-VTE; VTE diagnosed during hospital admission or within 90 days of discharge) accounts for a significant proportion of all VTE events.Data from countries where the use of specific VTE risk assessment tools and appropriate thromboprophylaxis is mandatory (and incentivized) have demonstrated that the implementation of these strategies significantly reduces mortality as a result of HA-VTE.Despite the evidence that these measures save lives, an ad hoc approach to the use of VTE risk assessment/thromboprophylaxis is frequently adopted. Moreover, in many healthcare systems very few data describing incidence of HA-VTE have been reported and consequently the magnitude of this potentially preventable source of hospital deaths is likely to be underestimated.We aimed to determine the incidence of VTE and of HA-VTE within the population served by the Ireland East Hospital Group (IEHG; the largest hospital group within the Irish healthcare network) as a first step towards promoting the implementation of a mandatory VTE risk assessment policy on a national level.MethodsA retrospective observational study was conducted where data pertaining to the diagnosis of VTE during the period January 2016 to October 2017 were collected. The IEHG is comprised of 11 hospitals serving a population of over 1 million individuals from urban and rural areas, affluent areas as well as economically disadvantaged areas and includes large tertiary academic centers as well as smaller community hospitals and the national maternity hospital.Data were obtained from NQAIS Clinical (National Quality Assurance Intelligence system - Clinical), an online reporting tool which is populated by anonymised data extracted from the hospital in-patient enquiry system (HIPE; a reporting tool which compiles diagnostic data on all patients by ICD-10 code at the time of discharge from hospital). In NQAIS clinical, VTE events are categorised as primary if they represented the reason for hospital admission or secondary if they were diagnosed during the period of hospitalisation. The term secondary VTE can therefore be understood to represent a surrogate-marker for HA-VTE; however, this methodology would be predicted to underestimate the total number of HA-VTE events as VTE diagnosed following discharge but within 90 days would be incorrectly categorised as primary events. Currently, no measures exist within our current data recording systems which can accurately capture post-discharge HA-VTE.ResultsDuring the 22-month study period, 2727 VTE events were reported. Using population data derived from the 2016 census, we then estimated the annual incidence of VTE within the IEHG catchment area (population 1,036,279) at 1.44 per 1000 person years (95% CI 1.36-1.51). VTE incidence by gender was similar for all age groups however a progressive increase in VTE incidence was observed (predictably) with increasing age, with the highest incidence reported among individuals aged over 85 years (16.03 per 1000 person years; 95% CI 12.81-19.26). The majority of VTE events were diagnosed in the two large academic teaching hospitals of the IEHG (1620 VTE events; 59.4%). The vast majority of cases were reported in the context of an emergency hospital admission (89.2%).Of the total number of VTE events diagnosed during the study period, 1273 (47%) were reported as secondary events (i.e. diagnosed during the period of hospital admission) and, as such, this figure represents an approximation but most likely a significant underestimation of the total proportion of hospital-acquired events.Within this category of HA-VTE/secondary VTE diagnoses, the most frequently reported primary diagnoses leading to the initial hospital admission were cancers (16.4%) followed by respiratory disease (14.6%) and cardiovascular disorders (13.5%).ConclusionWithin a population of over 1 million individuals, where formal VTE risk reduction strategies have yet to be implemented universally, at least 47% of all VTE are hospital-acquired. Given the compelling evidence which has shown that HA-VTE is a leading source of (preventable) hospital mortality, these findings provide a clear rationale for implementing formal VTE risk reduction strategies at hospital-group and national level. DisclosuresKevane:Leo Pharma: Research Funding. Ni Ainle:Leo Pharma: Research Funding; Actelion: Research Funding; Bayer: Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees; Daiichi Sankyo: Membership on an entity's Board of Directors or advisory committees; Boehringer: Membership on an entity's Board of Directors or advisory committees.

Care of Women with Obesity in Pregnancy

Care of Women with Obesity in Pregnancy

Identifying the Population Sources of Alcohol Impaired Driving: An Assessment of Context Specific Drinking Risks

High-risk drinkers who drink in high-risk contexts like bars are recognized as a primary source of alcohol-impaired drivers and motor vehicle crashes within communities. We assess the contributions of drinking in other contexts to these outcomes. Self-report survey data from 8,553 adults in 50 California cities were used to estimate rates of driving after drinking (DAD; driving within 4 hours of drinking any alcohol) and a measure of alcohol-impaired driving (AID; driving when having had "too much" to safely drive home) associated with drinking in bars, homes, restaurants, parties, and other contexts. Frequent drinking (b = .0588, z = 2.17, p = .030) and drinking outside the home, χ2(4) = 74.46, p < .001, at bars (b = .1418, z = 1.97, p = .049), and at restaurants (b = .2694, z = 5.60, p < .001) were related to greater DAD; lower risks were associated with drinking at home (b = -.0607, z = -2.16, p = .031). AID frequency was directly proportional to DAD (b = .0863, z = 8.43, p < .001) with no differences observed across contexts. Within a community of 100,000 persons over 6 months, 879 AID events were attributed to drinking at 102 restaurants and 726 AID events to drinking at 15 bars. Drinking at bars and restaurants contributes about equally to DAD and AID, with AID events concentrated in small populations that frequent relatively few bars and broadly distributed across large populations that frequent many restaurants. High frequencies of drinking at home were also associated with surprisingly large numbers of DAD and AID events. Observed differences between individual and community risks for DAD and AID must be addressed in place-based community prevention programs.

TBML suspicious activity reports – a financial intelligence unit perspective

PurposeThe purpose of this paper is to share research data from the Financial Intelligence sector on trade-based money laundering (TBML), as a way to better inform banking risk assessment and the submission of suspicious activity reports (SARs).Design/methodology/approachThe research data formed part of a bigger project on TBML banking risk assessment for improving the detection of TBML activity. This paper analysed the data from an online survey carried out among the financial intelligence staff from financial intelligence units (FIUs) and some external financial intelligence agencies. The aim was to determine which areas of banking SARs needed to be improved or enhanced to support FIU investigations.FindingsThe research found that FIUs do use the data supplied to them, in particular the SARs. The research also found that more data would be appreciated from banks especially in relation to beneficial ownership information and politically exposed persons data. The findings highlighted that contact between banks and FIUs was limited and restricted to a couple of key individuals, whereas the increased requirement for intelligence and more data would suggest that this relationship needs to be expanded and strengthened.Research limitations/implicationsThe main limitation was the restricted scope of the survey (only focussed on TBML) and was broad in depth, and perhaps a local FIU survey would be useful to look at specific country recommendations. Similar research also needs to be conducted on other forms of ML activity. The research identified the need for more information on beneficial ownership information; however, other work needs to be done on how exactly banks can access this data.Practical implicationsThe main outcome from the research was the need for SARs to contain more detailed information on beneficial ownership and politically exposed persons data. This needs to be incorporated into a specific risk assessment tool for TBML that considers not only the client but also relevant business partners and silent partners/shell companies used by the client. This research is part of a bigger research project that has developed a risk matrix tool for TBML and can be linked into this work.Originality/valueThe paper used original data collected by the researcher from 49 FIU and financial intelligence staff across the globe. The timely presentation of the results and the nature of the sample means that this is relevant and useful data to be presented to the banking sector.