Applying precaution to environmental health issues at the local level: A proposed guide based on the research and experiences of Toronto Public Health

Abstract

While the Precautionary Principle (PP) is an important policy innovation relevant to public health, practitioners do not agree on how or when it should be applied. Action on environmental health issues at Toronto Public Health (TPH) has clearly been informed by the PP. We have recently developed a guide to applying precaution that can be used to assist local public health practitioners in decision making to address environmental health hazards in the community. We applied the Guide retrospectively to TPH case examples involving education, program, policy, legislative, and advocacy interventions to manage exposures to environmental hazards. This exercise served to refine the Guide and increase our understanding of how and when TPH has applied precaution in the past. Our Guide promises to be a useful decision making support tool that will help users (1) assess what degree of precaution is appropriate for a given context; (2) systematically document evidence about harms and exposures (including uncertainties) while making the assumptions about evidence more explicit and transparent; (3) highlight potential trade-offs (including consideration of both risks and benefits), explore alternatives, and assess feasibility of interventions; (4) plan adequate communication and stakeholder engagement; and (5) institute monitoring and evaluation so as to ensure interventions still meet users’ needs. We see the Guide as a tool that deepens the process of learning and enquiry on issue management in environmental health practice. We urge others to share their applications of the PP using our Guide to promote mutual learning.