Commentary: Barriers and Opportunities to Changing the Research Agenda to Support Precaution and Primary Prevention

Abstract

Conceptual research to define the Precautionary Principle and its rôle in science, science policy, and public health is making substantial progress. In September 2001, participants at the International Summit on Science and the Precautionary Principle developed a vision for science to address the complexity of contemporary health risks in a way that could lead to more precautionary, preventive decisions under uncertainty. Its components include: (1) a more effective linkage between research on hazards and research on primary prevention; (2) increased use of interdisciplinary approaches including better integration of qualitative and quantitative data; (3) innovative methods for analyzing cumulative and interactive effects, populations and systems and vulnerable sub-populations; (4) systems for continuous monitoring to avoid unintended consequences of actions and to identify early warnings of risks; (5) more comprehensive techniques for analyzing and communicating hazards and uncertainties; and (6) a more dynamic interface between science and policy. This article addresses barriers and opportunities to the practical application of this vision for science. Scientists in many fields have recognized the need for innovative approaches and tools to address increasingly complex, uncertain risks of a global scale. While opportunities to apply precautionary concepts in the research agenda exist, public health scientists must be cognizant of current and emerging barriers in the research agenda that balance the research focus on characterizing proximate causal mechanisms of disease, to the detriment of research and policy to support primary prevention.

Keywords:

• precaution
• primary prevention
• research agenda
• interdisciplinary

Acknowledgements

This article was supported in part by grants from the V. Kann Rasmussen Foundation and the New York Community Trust. The author acknowledges the assistance of Dr. David Kriebel and Ms. Sara Wright in preparation of the manuscript.

This article is reprinted with permission from the European Journal of Oncology Library, vol. 2, 2003, with which the copyright resides. Address correspondence to Prof. Joel A. Tickner, Research Professor, Department of Work Environment, University of Massachusetts, Lowell, One University Ave, Lowell, MA 01854, USA. E-mail: [email protected]

Notes

^aThe Supreme Court struck down an occupational health standard for benzene on the grounds that the agency had not demonstrated significant risk with substantial evidence. The case ushered in a requirement for agencies to demonstrate that a hazard represented a significant risk before establishing an occupational health standard with the Court, stating that Congress was not concerned with absolute safety but elimination of significant harm and that the standard must be supported by a body of reputable scientific thought.

^bFor example, the author was involved in a Massachusetts Department of Environmental Protection scientific committee developing guidance for assessing the cumulative risks of solid waste facility siting. Agency officials noted that perhaps they should not apply cumulative risk methods because they are too complex and not widely accepted. However, the fact that such risks are difficult to study does not mean that they are not occurring.