Washington State Public Health Association, October 16, 2006

WASHINGTON STATE PUBLIC HEALTH ASSOCIATION ADOPTS PRECAUTION

[Rachel's introduction: The Washington State Public Health Association endorsed the precautionary principle October 16 "as a vital component of our preventive approach to public health in Washington State, advancing the goal that all people have an opportunity to reach and maintain their full potential."]

Title: Endorsing the Precautionary Principle as a Public Health Tool for Preventing Harm from Persistent Bioaccumulative Toxic Chemicals (PBTs)

Whereas: Every resident of Washington State has an equal right to conditions that protect and promote human health, including a healthy and safe environment, with all children of Washington State having an equal right to conditions that ensure they can reach and maintain their full potential, and

Whereas: Washington State recognizes that "health is a state of complete physical, mental and social wellbeing, not merely the absence of disease or infirmity" and a fundamental human right[1]; and

Whereas: Many conditions, including asthma, cancer, Alzheimer's disease, Parkinson's disease, birth defects, behavioral disorders, Autism, and chemical sensitivities, have been linked to environmental toxicants which incur enormous individual and societal costs in Washington State[2] and nationally[3]; and

Whereas: This growing knowledge confers an ethical responsibility and duty to make decisions that promote and maintain human and environmental health, thereby preventing disease, illness or disability[4,5]; and

Whereas: A principle for guiding activities to promote a healthy and safe environment and encourage human health is known as the Precautionary Principle, which consists of four basic elements: 1) taking preventive action in the face of uncertainty, 2) shifting the burden of responsibility of safety to the proponents of an activity; 3) exploring and implementing safer alternatives to possibly harmful actions, and 4) increasing public participation in decision making; and

Whereas: While scientific studies have determined that even low-level exposures to PBTs may cause serious and permanent health and neurodevelopmental harm, it is difficult to directly attribute a particular exposure to a particular illness or injury, emphasizing the need to take action to prevent harm[6]; and

Whereas: The precautionary principle holds that when an activity threatens harm to human health or to the environment, precautionary measures should be taken, even if cause-and- effect relationships are not fully established scientifically[7,8]; and

Whereas: Taking precautionary action is the common sense idea behind many adages, such as "be careful", "better safe than sorry" and "look before you leap" and is inherent in the understanding of the Hippocratic oath of "first, do no harm", in essence, the principle goes hand in hand with prevention, the cornerstone of public health; and

Whereas: Precautionary action is the basis of many activities designed to protect the health and safety of United States citizens, such as requirements of the federal Food and Drug Administration to ensure that new drugs are efficacious and safe before being placed on the market, requirements of the federal Occupational Safety and Health Act of 1970 that require employers to provide safe workplaces and working conditions, and the Food Quality Protection Act of 1996 that acknowledges additional protection for children; and

Whereas: The precautionary principle has been incorporated in international environmental treaties and in health, environment and educational policies of numerous governmental entities in the United States, including the city of San Francisco, and that Seattle includes a statement on the precautionary principle in the City's Comprehensive Plan[9, 13]; and

Whereas: The precautionary principle is a highly effective decision- making tool for reducing negative and costly effects on human health resulting from exposure to environmental toxicants[10]; and

Whereas: The Washington State Department of Ecology has developed a comprehensive strategy, based on preventing harm to human and environmental health, to reduce and eventually eliminate persistent bioaccumulative toxic chemicals (PBTs), further developing an accompanying PBT Rule which incorporates tenets of prevention [11,12] and

Whereas: The Washington State Departments of Ecology and Health have developed chemical action plans recommending phase out of mercury[13] and polybrominated diphenyl ethers (PBDEs)[14] in order to protect human and environmental health; and

Whereas: The precautionary principle's preventive foundation promotes environmental and economic justice to protect the environment and to safeguard the health of all people of Washington State; and

Whereas: The precautionary principle has been endorsed by the American Public Health Association, with the APHA stating it "Reaffirms its explicit endorsement of the precautionary principle as a cornerstone of preventive public health policy and practice[15,16,17] and by hundreds of other organizations nationally and internationally, including the American Nurses Association[18]

Therefore, Be It

Resolved, that: The Washington State Public Health Association (WSPHA) endorses the Precautionary Principle as a policy-making, educational and advocacy tool for preventing harm to health, behavior and neurodevelopment from exposures to PBTs in Washington State; and be it further

Resolved, that: The WSPHA endorses the precautionary principle as a vital component of our preventive approach to public health in Washington State, advancing the goal that all people have an opportunity to reach and maintain their full potential.

References

[1] WHO Alma-Ata Declaration (1978).

[2] Davies, K. Economic Costs of Diseases and Disabilities Attributable to Environmental Contaminants in Washington State. Davies, K. "How Much Do Environmental Disabilities and Diseases Cost?"; Northwest Public Health; Fall/Winter 2005.

[3] Landrigan, P. J., Schechter, C. B., Lipton, J. M., Fahs, M. C., and Schwartz, J. (2002). Environmental pollutants and disease in American children: estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities. Environ Health Perspect 110, 721-8.

[4] Gilbert, S. (2005). Ethical, Legal, and Social Issues: Our Children's Future. Neurotoxicology 27.

[5] Rosenblatt, R. A. (2005). Ecological change and the future of the human species: can physicians make a difference? Ann Fam Med 3, 173-6.

[6]. Szpir, Michael. Tracing the Origins of Autism: A Spectrum of New Studies; Environmental Health Perspectives Volume 114, Number 7, July 2006.

[7] Tickner, J. A. (2002). Precautionary principle encourages policies that protect human health and the environment in the face of uncertain risks. Public Health Rep 117, 493-7.

[8] Gilbert, S.G. (2005). Public Health and The Precautionary Principle. Northwest Public Health, Spring/Summer 2005, 4.

[9] Environment Element, City of Seattle's Comprehensive Plan, Department of Planning & Development (2005).

[10] Ashford, N. A. (2004). Implementing the Precautionary Principle: incorporating science, technology, fairness, and accountability in environmental, health, and safety decisions. Int J Occup Med Environ Health 17, 59-67.

[11] Washington State Department of Ecology; Proposed Strategy to Continually Reduce Persistent Bioaccumulative Toxins (PBTs) in Washington State, Ecology publication #00-03-054;

[12] Washington State Department of Ecology, PBT Rule Chapter 173-333 WAC;

[13] Washington State Department of Ecology and Department of Health; Washington's Mercury Chemical Action Plan;

[14] Washington State Department of Ecology and Department of Health; PBDE Chemical Action Plan

[15] Raffensperger, C., Tickner, J., ed. (1999). Protecting Public Health & the Environment: Implementing the Precautionary Principle. Island Press, Washington, D.C.

[16] 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.

[17] APHA Policy Statement #200011: The Precautionary Principle and Children's health. APHA Policy Statements; 1948-present, cumulative. Washington, DC: American Public Health Association.

[18] List of endorsing organizations as well as additional information on the Precautionary Principle is in the Seattle Precautionary Principle White Paper: A Policy Framework for Adopting the Precautionary Principle. The white paper and more updated date information is available here.

Individuals and Organizations Endorsing the Resolution, "Endorsing the Precautionary Principle as a Public Health Tool for Preventing Harm from Persistent Bioaccumulative Toxic Chemicals (PBTs):

Karen Bowman, MN, RN, COHN-S Washington State Association of Environmental and Occupational Health Nurses

Patricia Butterfield, PhD, RN Professor and Chair, Dept. of Psychosocial and Community Health Nursing University of Washington

Judy Huntington, MN, RN Executive Director Washington State Nurses Association

Elise Miller, M, Ed. Institute for Children's Environmental Health

Molly Parker MD, MPH

Janet Primomo, PhD, RN Associate Professor, University of Washington, Tacoma

L.B. Sandy Rock, MD, MPH

Margaret Shield, PhD Coordinator, Toxic-Free Legacy Coalition

Washington State Nurses Association

Washington Physicians for Social Responsibility

Institute of Neurotoxicology & Neurological Disorders

Institute for Children's Environmental Health

Selected State Organizations Which have Publicly Supported Phase Out of PBTs

Washington State Public Health Association Washington State Medical Association Washington Academy of Family Physicians Washington Chapter of the American Academy of Pediatrics Washington State Nurses Association Washington Physicians for Social Responsibility Washington State Association of Occupational Health Nurses

Selected Organizations Supporting Precautionary Principle

American Public Health Association -- The Precautionary Principle and Children's Health -- The Precautionary Principle and Chemical Exposure Standards for the Workplace -- (APHA-pdf)

American Public Health Association (2002) -- The Precautionary Principle and Children's Health American Nurses Association Washington State Nurses Association, Supporting Precautionary Approach Towards Occupational and Environmental Health American Commission for Environmental Cooperation -- North American Environmental Law and Policy Series, Volume 10 Access to environmental information / The precautionary principle. (accessed: 13 June 2005). Physicians for Social Responsibility (National PSR) Washington Physicians for Social Responsibility City of San Francisco (2002) -- SF Precautionary Principle Ordinance Los Angeles Unified School District (2nd largest district in USA) City of Seattle; Introduction to Comprehensive Plan Berkeley City Council Resolution, October 2003, which also called for the development of a precautionary principle ordinance, beginning with an Environmentally Preferable Purchasing Policy within a year. California Cal/EPA -- Environmental Justice Action Plan Portland, Oregon Earth Charter World Trade Center Clean Up -- NYCOSH statement

Submitting Primary Author: Steven G. Gilbert, PhD, DABT -- WSPHA Member -- Yes INND (Institute of Neurotoxicology & Neurological Disorders) 8232 14th Ave NE Seattle, WA 98115 Ph: 206.527.0926 Fx: 206.525.5102 E-mail: sgilbert@innd.org Web: www.asmalldoseof.org

Co-Author: Kate Davies, M.A., D.Phil. -- WSPHA Member -- Yes Core Faculty, Environment & Community Antioch University Seattle 2326 Sixth Avenue Seattle, WA 98121 206 268 4811 kdavies@antiochsea.edu