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A risky preposition

Q: I see both “risk of” and “risk for” regularly, particularly in the health context. “Risk for cancer,” “risk of dying prematurely,” etc. How do you know when to use “of” or “for”? Are both acceptable?

A: There’s no clear answer here. Both “risk of” and “risk for” are used by educated writers, and many of them—medical writers in particular—seem to use the two interchangeably.

In searches of scholarly databases, we found scores of books and articles in which both “risk of” and “risk for”—or “at risk of” and “at risk for”—appear in otherwise identical phrases.

Some examples: “assessing risk of violence” and “assessing risk for violence” (2010) … “at high risk of death” and “at high risk for death” (2001) … “risk for dementia” and “risk of dementia” (1999) … “at risk of falling” and “at risk for falling” (1998) … “at risk for school failure” and “at risk of school failure” (1989) … “the risk of reinfection” and “the risk for reinfection” (1986).

We have the impression that in some cases the writer (or editor) alternated the pattern merely for the sake of variety.

Scholarly usage aside, people in general tend to prefer “risk of” to “risk for,” whether or not the phrase is preceded by “at.” Google hits for “at risk of” outnumber “at risk for” by almost two to one.

If there’s a pattern here, it may have to do with the noun or noun phrase that follows “of” or “for” and whether it represents the danger itself or whatever is in danger.

We’ve concluded that both “risk of” and “risk for” are common when the object of the preposition is the noun or noun phrase for the danger—the disease or other misfortune.

But “risk of” is more popular, especially when the object is a gerund (an “-ing” word), as in “Climbers run the risk of falling” … “He spoke up at the risk of sounding foolish.”

The Oxford English Dictionary’s entry for “risk” has many citations, from the 1660s to the present, in which “risk of” precedes the noun or noun phrase for the hazard or misfortune.

A sampling: “an heavy Risk of wickedness” (1660) … “the Risque of being hang’d” (1697) … “the Risque of an Insult” (1740) … “the risk of flooding” (1934) … “great risk of wildfire” (2003).

In fact, within its “risk” entry the OED has no citations at all for “risk for.” However, elsewhere in the dictionary are numerous examples of “risk for,” all from the 20th century or later and almost all from medical writing.

So it would appear that “risk for” is a relatively recent usage, at least in the sense that we’re discussing. (We’re ruling out constructions like “he ran a risk for her sake” or “he put his life at risk for his country.”)

On the other hand, when the “risk” phrase precedes the thing at risk, not the hazard or misfortune, we generally find “risk to” (sometimes “risk for”), as in “Strong chemicals are a risk to (or for) nail salon workers” … “Pollution poses risks to (or for) the environment.”

Oxford has many examples in which “risk to” precedes what’s in danger: “at great risk to himself” (1805) … “at risk to their lives” (1905) … “a risk to others” (1979) … “at grave risk to his career” (2002) … “a risk to himself and others” (2002).

In 2011 the linguist Mark Liberman wrote an article on the Language Log in rebuttal to a reader who insisted that “at risk for cancer” is grammatically incorrect.

In his article, which he filed under “Prescriptivist Poppycock,” Liberman suggested the reader’s peeve was an “individual quirk.”

A couple of comments suggested that “at risk for” became established largely because of its use in epidemiology. Another noted, “Once ‘at risk’ becomes an expression that stands on its own, it becomes quite natural to use ‘for’ to specify what they are at risk for (eh, of).”

The noun “risk” first appeared in written English in the 17th century, according to OED citations.

Its ancestors were recorded in medieval Italian (rischio) and post-classical Latin (resicum, risicum, etc.), but can’t be traced back further than the mid-1100s (as Oxford puts it, “further etymology uncertain and disputed”).

The noun came into Middle French in the 16th century as risque, meaning “danger or inconvenience, predictable or otherwise,” the OED says. And English speakers borrowed the word from French in the following century.

The first known example in writing is from The Wise Vieillard, or Old Man, an anonymous 1621 translation of a work by the French theologian Simon Goulard:

“The couetous [covetous] Marchant to runne vpon all hazards and risques for a handfull of yellow earth.”

The OED notes that the noun appears “freq. with of.” The earliest such example is from John Sadler’s mock-utopian work Olbia (1660), in a reference to “an heavy Risk of wickedness.”

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