Development of a guide to applying precaution in local public health

Abstract

Purpose: The precautionary principle (PP) urges actions to prevent harm even in the face of scientific uncertainty. Members of Toronto Public Health (TPH) sought guidance on applying precaution. Methods: We searched five bibliographic databases (yield 60 articles from 1996 to 2009 and 8 from 2009 to 2011) and Google (yield 11 gray literature sources) for material relevant to local public health. From these sources, we extracted questions until saturation was reached (n555). We applied these questions retrospectively to eight case studies where TPH felt precaution was applied. We ranked questions for their importance in applying precaution. Results: Our final guide included 35 questions in five domains: context, assessment, alternative interventions, implementation, and monitoring and evaluation. Importance rankings varied across cases, but the role of stakeholders in driving precautionary action was consistent. Monitoring and evaluation components could have been strengthened across cases. Conclusion: The TPH guide can assist municipal environmental health practitioners in applying precaution in a more transparent manner.

A Health Justice Agenda for Local Governments to Address Environmental Health Inequities

“…This means erring on the side of caution where there are reasonable grounds for concern about the potential for deleterious harms, even in situations where the evidence of harm and/or exposure for a particular hazard is incomplete or evolving, in order to avoid and mitigate risk to the public's health at the outset of a project or activity. 53 While there is debate about the costs of utilizing the precautionary principle in the face of scientific uncertainty, 54 jurisdictions, such as the European Union, have approached the issue by recommending taking action when there is "reasonable grounds for concern" about potential risks, and subjecting regulatory measures introduced as a result of the precautionary principle to review and modification in light of new scientific data. 55 Additionally, local governments may be better situated to incorporating the precautionary principle due to the smaller costs of doing so compared to higher levels of government, allowing for action to be taken in face of uncertainty while science is evolving with solutions bubbling up to higher levels of government as it does.…”

WHO guidelines on protecting workers from potential risks of manufactured nanomaterials

“…Several definitions of a precautionary approach exist. All include a component that urges acting despite uncertainty when there are reasonable indications to do so (15).…”