Major Issues in the Environmental Health Decision-Making Process
Tong, Shilu, Lu, Ying, Journal of Environmental Health
In 1965, the British statistician Sir Austin Bradford Hill commented, "All scientific work is incomplete - whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us a freedom to ignore the knowledge that we already have, or to postpone the action that it appears to demand at a given time" (1). His commentary is splendid and insightful. Presently, a challenge both scientists and decision makers face is determining how much knowledge or evidence is sufficient to initiate action and what the best approach is to transferring research into decision making.
In the area of environmental health decision making, many questions remain to be answered. For example, should we take any action on the basis of the available evidence about the possible health effects of exposure to residential electric and magnetic fields? Should we use alternatives to chlorination in drinking water because chlorination by-products may increase cancer risk? Do we need greater certainty before reducing greenhouse gas emissions? We have no easy answers to these questions. Clearly, decisions should be made on the basis of accumulated scientific evidence. Nevertheless, there is disagreement: People who advocate "precautionary principles" believe we should do something right now rather than wait and see; people who adopt a "conservative approach" insist that we gather more information before taking any action.
To make the best use of research findings in the formulation of environmental health policy, both scientists and decision makers need to break down current communication barriers. Also, we need to improve our understanding of key issues in the environmental health decision-making process.
What Is the Environmental Health Decision-Making Process?
The environmental health decision-making process may be defined as the formulation of a set of principles or standards for assessing, controlling, and preventing the health impacts of environmental hazards, as well as for improving the health status and well-being of the whole population by optimizing the underlying environmental determinants of human health. Since there has been little discussion in the literature about how to define the environmental health decision-making process, the definition proposed here is open for debate.
Why Is the Environmental Health Decision-Making Process Important?
Edmund Burke, the British historian and philosopher, noted more than 100 years ago that "all that is necessary for the force of evil to triumph is for a few good men to do nothing" (2). Likewise, scientists will contribute to the degradation of environmental quality and human health by doing nothing with the results of environmental health research. It has been increasingly recognized in the scientific community that environmental epidemiologists, exposure/risk assessors, and environmental health officers should take active and significant roles in the environmental health decision-making process.
Who Makes Decisions?
Decisions usually have been made, at least in part, within the wider government system, including federal, state, and local governments. Most decisions involve - and impinge on - a wide range of stakeholders and actors (3):
* Elected officials are charged with making the decisions. Their attitudes and beliefs have a significant impact on the decision-making process.
* Scientists may be involved in the initial research that has identified a problem, as well as in helping to devise solutions. They commonly play a limited role in the environmental health decision-making process.
* Business and industry may be implicated in the cause of the problem and may be partly responsible for implementing and financing solutions. Their concerns and attitudes usually influence the decisions of elected officials. …