Reenergizing public health through precaution

The precautionary principle has provoked a spirited debate among environmen talists worldwide, but it is equally relevant to public health and shares m uch with primary prevention. Its central components are (1) taking preventi ve action in the face of uncertainty; (2) shifting the burden of proof to t he proponents of an activity; (3) exploring a wide range of alternatives to possibly harmful actions; and (4) increasing public participation in decis ion making, Precaution is relevant to public health, because it can help to prevent unintended consequences of well-intentioned public health interven tions by ensuring a more thorough assessment of the problems and proposed s olutions. It can also be a positive force for change. Three aspects are str essed: promoting the search for safer technologies, encouraging greater dem ocracy and openness in public health policy, and stimulating reevaluation o f the methods of public health science.