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The Precautionary Principle and Children’s health

Policy Date: 1/1/2000
Policy Number: 200011

THE AMERICAN PUBLIC HEALTH ASSOCIATION,
Recognizing that, for centuries, the cornerstone of public health policy and practice has been the prevention of injury and disease; and
Recognizing that the US has signed the Rio Declaration on Environment and Development which states;
In order to protect the environment, the precautionary approach shall be widely applied by States according to their capabilities. Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation, a statement known as the Precautionary Principal;1 and
Recognizing that the American Public Health Association has previously encouraged the implementation of the Precautionary Principle with regard to workplace chemical exposure prevention policies;2 and
Recognizing that current environmental regulations are primarily aimed at controlling pollution rather than using primary preventive measures to avoid the use, production, or release of toxic materials;3 and
Recognizing that development of enterprises, projects, technologies, products, and substances, that may adversely affect public health proceeds through initiatives that may or may not have considered a range of safer alternatives;4 and
Recognizing that many of these enterprises, projects, technologies, products, and substances are considered safe until proven harmful; and
Recognizing that public health decisions must often be made in the absence of scientific certainty, or in the absence of perfect information; and
Recognizing that some industries engaged in the production, release, or distribution of potentially hazardous products and processes use their influence to delay preventive action, arguing that the immediate expense of redesign to achieve pollution prevention is unwarranted, lacking scientific certainty about harmful health effects;5 and
Recognizing that fetuses, children, and all developing organisms are often more susceptible to environmental contaminants than adults, and that agency policies and decisions often fail to reflect this unique susceptibility;6 and
Recognizing that proof of cause and effect relationships is often difficult to establish because of non-specificity of health effects, long latent periods, subtle changes in function that are difficult to detect without resource-intensive studies, and complex interactions of variables that contribute to adverse health effects;7 and
Recognizing that some lack of scientific certainty is irresolvable by more data collection; that some residual lack of scientific certainty is actually the result of indeterminacy due to multiple factors interacting in complex systems or due to ignorance about what questions to ask or what effects to look for;8 and
Declaring that children and other sensitive populations are, therefore, in particular need of protection from environmentally related hazards; and
Recognizing that Presidential Executive Order #13045 requires that all federal agencies, when developing policies, must explicitly consider their impacts on children, therefore,
• Reaffirms its explicit endorsement of the precautionary principle as a cornerstone of preventive public health policy and practice, both in the U.S. and throughout the world;
• Encourages governments at all levels, the private sector, and health professionals to promote and abide by this principle in order to protect the health and well-being of all developing children. Thus, APHA calls for explicit inclusion of the precautionary approach in all federal, state, and local legislation, rules, or policies intended to protect children or that may impact the health of children;
• Urges that whenever an enterprise, project, technology, product, or substance is proposed for initiation, manufacture, or use or continued manufacture or use the goal of public health advocates should be to reduce or eliminate the creation of conditions that may adversely impact reproductive health, infants, or children;
• Advocates significant increases in pollution prevention efforts through clean production, assessment of safer alternatives, energy efficiency, waste minimization, safer waste disposal methods, and reduced consumption as a general means to protect children’s health and development, rather than relying on risk management of individual hazards;
• Encourages explicit consideration of the kinds and magnitude of harm to reproductive health, infants, or children that may result from an activity and its alternatives;
• Encourages explicit consideration of the kinds and magnitude of uncertainties inherent in assessing potential harm to reproductive health, infants, or children from an activity and its alternatives;
• Encourages precautionary action to prevent potential harm to reproductve health, infants, and children, even if some cause and effect relationships have not been established with scientific certainty;
• Urges scientists to engage in analysis and studies to develop implementation strategies using the precautionary principle that are based on sound science.
• Enunciates the urgent need for improved research methods to understand better the additive, cumulative, and synergistic effects of multiple stressors on children’s development and health; and.
• Urges the United States to honor and explicitly refer to the precautionary principle during negotiations of international agreements, while working to establish the precautionary principle as a guiding principle of environmental and health-related international law.

References
1. Rio Declaration on Environment and Development (July 14, 1992). ILM. 1992; 31:873.
2. APHA Policy Statement #9606: The Precautionary Principle and Chemical Exposure Standards for the Workplace. APHA Policy Statements; 1948–present, cumulative. Washington, DC: American Public Health Association.
3. Ashford N, Caldart C. Technology, Law and the Working Environment. Washington, DC: Island Press, 1997. Jackson T (ed). Clean Production Strategies: Developing Preventive Environmental Management in the Industrial Economy. Boca Raton, FL: Lewis Publishers, 1993.
4. O’Brien, M. Making Better Decisions. Cambridge, MA: MIT Press, 2000.
5. Markowitz G, Rosner D. Cater to the children: The role of the lead industry in a public health tragedy, 1900-1955. Am J Public Health. 2000; 90:36-46. Fagin D, Lavelle M. Toxic Deception: How the Chemical Industry Manipulates Science, Bends the Law, and Endangers Your Health. Seacaucus, NJ: Birch Lane Press, 1996.
6. National Research Council. Pesticides in the Diets of Infants and Children. Washington, DC: National Academy Press, 1993.
7. Raffensperger C, Tickner J (eds). Protecting Public Health and the Environment: Implementing the Precautionary Principle. Washington, DC: Island Press, 1999.
8. See 7 and 3.