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The London smog of 1952 is one of history's most important air pollution episodes in terms of its impact on science, public perception of air pollution, and government regulation. The association between health and air pollution during the episode was evident as a strong rise in air pollution levels was immediately followed by sharp increases in mortality and morbidity. However, mortality in the months after the smog was also elevated above normal levels. An initial government report proposed the hypothesis that influenza was responsible for high mortality during these months. Estimates of the number of influenza deaths were generated using multiple methods, indicating that only a fraction of the deaths in the months after the smog could be attributable to influenza. Sensitivity analysis reveals that only an extremely severe influenza epidemic could account for the majority of the excess deaths for this time period. Such an epidemic would be on the order of twice the case-fatality rate and quadruple the incidence observed in a general medical practice during the winter of 1953. These results underscore the need for diligence regarding extremely high air pollution that still exists in many parts of the world.

The London smog of 1952 is one of history's most important air pollution episodes in terms of its impact on science, public perception of air pollution, and government regulation. The association between health and air pollution during the episode was evident as a strong rise in air pollution levels was immediately followed by sharp increases in mortality and morbidity. However, mortality in the months after the smog was also elevated above normal levels. An initial government report proposed the hypothesis that influenza was responsible for high mortality during these months. Estimates of the number of influenza deaths were generated using multiple methods, indicating that only a fraction of the deaths in the months after the smog could be attributable to influenza. Sensitivity analysis reveals that only an extremely severe influenza epidemic could account for the majority of the excess deaths for this time period. Such an epidemic would be on the order of twice the case-fatality rate and quadruple the incidence observed in a general medical practice during the winter of 1953. These results underscore the need for diligence regarding extremely high air pollution that still exists in many parts of the world.

AbstractThose who conduct integrated assessments (IAs) are aware of the need to explicitly consider multiple criteria and uncertainties when evaluating policies for preventing global warming. MCDM methods are potentially useful for understanding tradeoffs and evaluating risks associated with climate policy alternatives. A difficulty facing potential MCDM users is the wide range of different techniques that have been proposed, each with distinct advantages. Methods differ in terms of validity, ease of use, and appropriateness to the problem. Alternative methods also can yield strikingly different rankings of alternatives. A workshop was held in which climate change experts and policy makers evaluated the usefulness of MCDM for IA. Participants applied several methods in the context of a hypothetical greenhouse gas policy decision. Methods compared include value and utility functions, goal programming, ELECTRE, fuzzy sets, stochastic dominance, min max regret, and several weight selection methods. Ranges, rather than point estimates, were provided for some questions to incorporate imprecision regarding weights. Additionally, several visualization methods for both deterministic and uncertain cases were used and evaluated. Analysis of method results and participant feedback through questionnaires and discussion provide the basis for conclusions regarding the use of MCDM methods for climate change policy and IA analyses. Hypotheses are examined concerning predictive and convergent validity of methods, existence of splitting bias among experts, perceived ability of methods to aid decision‐making, and whether expressing imprecision can change ranking results. Because participants gained from viewing a problem from several perspectives and results from different methods often significantly differed, it appears worthwhile to apply several MCDM methods to increase user confidence and insight. The participants themselves recommended such multimethod approaches for policymaking. Yet they preferred the freedom of unaided decision‐making most of all, challenging the MCDM community to create transparent methods that permit maximum user control. Copyright © 2002 John Wiley & Sons, Ltd.