BMAT Risk Assessment & Management 5 — Questions and Answers
Question 1: In environmental health risk assessment, the four-step framework established by the National Academy of Sciences includes all of the following EXCEPT:
- Hazard identification
- Dose-response assessment
- Risk communication audit (Correct answer)
- Risk characterisation
Correct answer: Risk communication audit
The four NAS steps are hazard identification, dose-response assessment, exposure assessment, and risk characterisation; a communication audit is not one of them.
Question 2: When calculating the Number Needed to Harm (NNH), which formula is correct?
- 1 / Absolute Risk Reduction
- 1 / Attributable Risk Increase (Correct answer)
- Relative Risk x Baseline Risk
- Odds Ratio / Baseline Odds
Correct answer: 1 / Attributable Risk Increase
NNH equals 1 divided by the absolute increase in risk (attributable risk increase) associated with the harmful exposure.
Question 3: A food safety inspector applies the HACCP (Hazard Analysis Critical Control Points) framework. A 'critical control point' is best defined as:
- Any step where contamination could theoretically occur
- A step where control can be applied to prevent or eliminate a food safety hazard (Correct answer)
- The final inspection before product release
- A documented consumer complaint procedure
Correct answer: A step where control can be applied to prevent or eliminate a food safety hazard
A critical control point is a specific process step where a control measure can be applied to prevent, eliminate, or reduce a food safety hazard to an acceptable level.
Question 4: Which cognitive bias most commonly leads risk assessors to underestimate the probability of rare but catastrophic events?
- Availability heuristic
- Anchoring bias
- Optimism bias (Correct answer)
- Confirmation bias
Correct answer: Optimism bias
Optimism bias causes people to believe that negative events are less likely to happen to them or their projects than the evidence warrants.
Question 5: A risk manager identifies that a control measure has become less effective over time due to staff complacency. This phenomenon is known as:
- Risk creep
- Control decay
- Normalisation of deviance (Correct answer)
- Risk appetite shift
Correct answer: Normalisation of deviance
Normalisation of deviance describes the gradual process by which deviation from safe practice becomes accepted as normal within an organisation.
Question 6: In the Swiss Cheese Model of accident causation, patient harm occurs when:
- A single defensive layer fails completely
- Holes in multiple defensive layers align simultaneously (Correct answer)
- A clinician makes an active error without any system failures
- The risk register is not updated after an incident
Correct answer: Holes in multiple defensive layers align simultaneously
James Reason's Swiss Cheese Model holds that accidents result when holes (weaknesses) in multiple defensive layers align to allow a hazard to reach the patient.
Question 7: A clinical governance team reviews its risk management framework annually. Which output should be directly informed by this review?
- Individual clinician performance reviews
- Updates to the organisation's risk register and risk appetite statement (Correct answer)
- Patient satisfaction survey design
- Staff recruitment criteria
Correct answer: Updates to the organisation's risk register and risk appetite statement
Annual framework reviews should lead to updated risk registers and revised risk appetite statements that reflect current organisational context.
BMAT Risk Assessment & Management 5
In environmental health risk assessment, the four-step framework established by the National Academy of Sciences includes all of the following EXCEPT: