Society For Risk Analysis Annual Meeting 2017

Session Schedule & Abstracts

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Common abbreviations

Roundtable: Understanding Perceptions of Benefits and Risks Posed by Microbiota of Milks

Room: Salon 2   10:30 am–12:00 pm

Chair(s): Ann Bostrom, Warner North

Sponsored by Risk Communication Specialty Group

Organizer: Peg Coleman, Upstate NY SRA/Coleman Scientific Consulting (
Moderators: SRA Past-Presidents
• Ann Bostrom ( and
• Warner North (

Description: Regulators and stakeholders around the world differ in their perceptions of risks and benefits of fresh unprocessed milks (human and bovine) and pasteurized milks. A joint SRA RO project began outreach documenting the state of the science on the microbiota of milks and engaging in dialogue with SRA practitioners and other stakeholders through a webinar series (podcasts, slide sets available). Two SRA Past-Presidents will moderate discussions of the evidence for risks and benefits of fresh unprocessed mother’s milk to infants, including a key study demonstrates loss of benefits for neonates in NICU environments that ingest Holder pasteurized donor milk. The moderators and panelists will discuss rationales for and against pasteurization in light of an emerging dimension: the microbiota of milks. Discussions will be grounded in the major elements of risk communication (trust, fairness, and emotionality). Various risk communication approaches (evidence mapping, mental modeling) will be considered. Also of keen interest is evidence for risks and benefits of fresh unprocessed bovine milk for consumers, including children and adults. Evidence mentioned in the symposium for human milks will be included, along with additional evidence for bovine milks, in exercises of analytic-deliberative process in the next phase of this multi-year joint RO project (a 2.5-day stand-alone SRA workshop in 2018). Participants in the symposium will discuss what is known about the healthy human milk microbiome, research gaps, researchable questions, and potential improvements in developing evidence-based policies and risk communications.

Confirmed panelists include:
• Cynthia Bearer, U MD Medical School (Chief of Neonatology/Associate Chair for Research)
• Peg Coleman, Upstate NY SRA (microbiology/microbial risks and benefits)
• Bill Hallman, Rutgers University (risk communication/food safety)
• Ellen Silbergeld, Johns Hopkins Bloomberg School of Public Health (health/environmental policy)
• Tanya Soboleva, Australia/New Zealand SRA (food science/risk assessment)

Scope and Structure of Round Table Panel Discussions

The focus for the round table panel symposium is on evidence for risks and benefits from fresh unprocessed and pasteurized human milks for infants (NICU and others). Input will be sought on the state of the evidence and key researchable questions necessary to inform future decision making for human donor milk in this phase of the project, and for bovine milk in the next stage of the project, the 2018 workshop.

Moderators Ann Bostrom and Warner North served as past presidents of SRA and offer decades of expertise in risk communication for controversial issues and analytic deliberative process. They will keep discussion focused on the evidence rather than on positions and perceptions. After brief introductions by the panelists, the moderators will pose the following questions to the panel. As time permits, questions will be posed by the risk practitioners in the SRA audience.

Questions for the Panel:

1. What changes are induced in breast milk by Holder pasteurization? What uncertainties remain in our knowledge of the effects of pasteurization on breast milk with regard to infant health and disease?

2. What are the risks and benefits of pasteurizing donor breast milk for infants (NICU and others)? How does pasteurization affect the development of infant microbiota, immune, and gastrointestinal systems? Transmission of and resistance to disease? The ability of infants to grow and thrive?

3. Why did Australia and New Zealand decide to require pasteurization of donor breast milk? Why did Norway decide not to require pasteurization of donor breast milk? What trends are observed for health and disease under the different risk management strategies?
4. What researchable questions might reduce uncertainties for risks and benefits and strengthen the scientific basis for evidence-based decisions?

5. Next topic (2018 workshop): What is evidence on risks and benefits of other milks (e.g., bovine)? How can stakeholders contribute to assessing and balancing risks and benefits for the microbiota of milks in the 21st century?

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