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A screening level human health risk assessment (HHRA) was applied to evaluate the human health implications of consuming selenium found in fish tissues collected downstream of coal mines in southeastern British Columbia, Canada. The study evaluated the potential for adverse human health effects associated with selenium, and considered known and potential benefits of selenium and fish ingestion. The results indicated that risks of selenosis due to consumption of selenium-contaminated fish in the region are negligible. Conclusions were strengthened by consideration of the potential benefits of selenium to human health, including: selenium essentiality for maintenance of good health; potential cancer prevention properties due to its role as an antioxidant; potential benefits for cardiovascular health; and other positive health benefits. The findings indicated that some aspects of the traditional framework for HHRA (e.g., application of safety factors to "err on the side of safety") are inappropriate for the assessment of selenium-contaminated fish. Due to both deficiency and toxicity in the selenium dose-response relationship, application of compounding conservatism in risk assessment may lead to recommended intakes of fish that are contrary to the public health interest. The need for balancing risk types, for incorporating positive responses in risk assessments, and the linkage to the precautionary principle, are discussed. [ABSTRACT FROM AUTHOR]

As technology advances rapidly, so do applications with potential adverse implications on human health. The possible threats include risks that can be substantial, far-reaching and irreversible, and currently available methods of investigation, designed to deal with direct exposure-disease associations, are not always suitable. Growing interest is being paid to health effects that may be the consequence of distal, “upstream” determinants. Considering the complex chain of events that links such determinants with health can be extremely difficult, and exposes severe limitations in science. Thus, there is often a mismatch between what is known and what would be required to inform rational, evidence-based decision making, which is increasingly called for. It has become apparent how production and use of scientific evidence in decision making must be accompanied by precaution, especially in those circumstances, more and more common in recent times, where there is an uncertain possibility that serious health consequences might take place. Several cautionary approaches have been proposed, but the Precautionary Principle (PP) has been the object of especially intense debate in recent years. Developed in the field of environmental health, the PP has been clarified, and has been applied or called for in several instances in public health. Although a unique definition is not available, the principle has been characterised, and criteria for its application have been proposed. However, many questions remain open on general as well as specific issues. In this paper, we address some of the questions that are relevant for the PP to support rational decision making in environment and health and more in general to strengthen its contribution towards human health protection. [ABSTRACT FROM AUTHOR]

The greater the potential for disastrous, large-scale, or catastrophic impacts on health, the greater the case for precaution. The imperative for precautionary action, critical also for downstream determinants of health, is at least as compelling where macro-level concerns about the sustainability of life on Earth are at issue. In this context, I propose that a higher threshold of uncertainty is needed where large-scale harms to health and well-being are possible. Initial efforts must focus on the training of researchers and risk managers for competencies in complexity, and in systems approaches to transdisciplinary enquiry. Revisiting the intent behind Bradford Hill on causation is an essential first step. Focus on the more proximate causes of diseases, such as those related either to occupational exposures or to more downstream environmental exposures, is left to others in this collection. [ABSTRACT FROM AUTHOR]

The article discussed implications of the Precautionary Principle (PP) for public health practice and research. The overall aim of the PP is to provide an approach to acting in the face of uncertainty. Like a single definition of the PP will probably not suffice, the various procedural aspects of the PP are currently being explored and discussed. This aspect is of particular interest at our conference. There is a need for an in-depth analysis of the role of the PP within the greater realm of decision-making in environmental health.