The Bioinitiative Report- Chapter 16

Late Lessons from Early Warnings and EMF
Mr. Gee



SECTION 16



“Late Lessons From Early Warnings:
Towards realism and precaution with EMF?”




David Gee, European Environment Agency
Kongens Nytorv 6
DK-1050 Copenhagen K










Disclaimer.

The views expressed are those of the author and do not represent the views of the
EEA or its Management Board. The author has no competing financial interest in the
matters dealt with.
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TABLE OF CONTENTS



I. INTRODUCTION
II.
THE TWELVE “LATE LESSONS FROM EARLY WARNINGS”
A. Identify/Clarify the Framing and Assumptions
B. Broaden Assessment Information
III.
EARLY USE OF PRECAUTION
IV.
KNOWLEDGE AND IGNORANCE REQUIRE PREVENTION AND
PRECAUTION

A. Prevention and Precaution
V.
THE PRECAUTIONARY PRINCIPLE: SOME DEFINITIONS AND
INTERPRETATIONS
A. Definitions and Interpretations of the Precautionary Principle
B. Reasonable Grounds for Concern?
C. The EEA Working definition of the Precautionary Principle
VI. DIFFERENT LEVELS OF PROOF FOR DIFFERENT PURPOSES
VII.
FALSE NEGATIVES AND FALSE POSITIVES
VIII. SOME CRITERIA FOR ESTABLISHING CAUSATION
1X.
PUBLIC PARTICIPATION IN RISK ANALYSIS
X. SOME EXAMPLES OF EARLY WARNINGS
A. Antibiotics in Animal Feed
B. Lead in Gasoline
C. Tributylin (TBR) – A Marine Antifoulant for Ships
D. Diethylstilbestrol (DES)
XI. CONCLUSION
XII. REFERENCES


Table 1: Clarification of Some Key Terms.

Table 2: Different Levels of Proof for Different Purposes
Table 3: On Being Wrong: Main Directions of Error in the
Environmental Sciences.




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I. INTRODUCTION

The histories of selected public and environmental hazards, from the first
scientifically based early warnings about potential harm, to the subsequent
precautionary and preventive measures, have been reviewed by the European
Environment Agency.( “Late Lessons from Early Warnings: the Precautionary
Principle 1896-2000”, EEA,2001). This paper summarises some of the definitional
and interpretative issues that arise from the report and subsequent debates, such as the
contingent nature of knowledge; the definitions of precaution, prevention, risk,
uncertainty, and ignorance; the use of differential levels of proof; and the nature and
main direction of the methodological and cultural biases within the environmental
health sciences. These issues are relevant to EMF.

II. THE TWELVE “LATE LESSONS FROM EARLY WARNINGS

The paper does not address the specifics of EMF hazards, leaving it to the reader to
apply, or not, the “Twelve late Lessons” that conclude the report. These lessons
attempt to synthesise the fourteen historical experiences from the very different case
study chapters into generic knowledge that can help inform policy-making on current
issues such as GMO., nanotechnologies, mobile phones, and endocrine disrupting
substances where the luxuries of hindsight are not yet available but where exposures
are already widespread and rising.

The idea of the twelve late lessons is to make the most of past experience to help
anticipate future surprises whilst recognising that history never exactly repeats itself.
When adopted alongside the best available science the lessons aim to help minimize
hazards without compromising innovation. The “lessons” are reproduced below.

A. “Identify/Clarify the Framing and Assumptions”
1. Manage “risk”, “uncertainty” and “ignorance”
2. Identify/reduce “blind spots” in the science
3. Assess/account for all pros and cons of action/inaction
4. Analyse/evaluate alternative options
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5. Take account of stakeholder values
6. Avoid “paralysis by analysis” by acting to reduce hazards via the
precautionary principle.

B. “Broaden Assessment Information”
7. Identify/reduce interdisciplinary obstacles to learning
8. Identify/reduce institutional obstacles to learning
9. Use “lay”, local as well as specialist knowledge
10. Identify/anticipate “real world” conditions
11. Ensure regulatory and informational independence
12. Use more long-term (ie. decades) monitoring and research

III. EARLY USE OF PRECAUTION

The Vorsorgeprinzip, or “foresight” principle, only emerged as a specific policy tool
during the German debates on the possible role of air pollution as a cause of “forest
death” in the 1970-80s. However, John Graham, one of Bush’s science policy
advisors, and trenchant critic of the precautionary principle, has noted that:

“Precaution, whether or not described as a formal principle, has served mankind
well in the past and the history of public health instructs us to keep the spirit of
precaution alive and well”. (Graham 2002).

Graham might have been thinking of the cholera episode of 1854 when precaution did
indeed serve the people of London well. Dr. John Snow, a London physician, used
the spirit of precaution to advise banning access to the polluted water of the Broad St.
pump which he suspected was the cause of the cholera outbreak. He based his
recommendation on the evidence he had been accumulating for some years including
his study of S. London populations served by both piped and well water. Snow’s
views on cholera causation were not shared by The Royal College of Physicians who
considered Snow’s thesis and rejected it as ‘untenable’ as they and other “authorities”
of the day believed that cholera was caused by airborne contamination. This particular
scientific “certainty” soon turned out to be certainly mistaken, with the last remaining
doubt being removed when Koch in Germany isolated the cholera vibrio in 1883.
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From the association between exposure to water polluted with human faeces, and
cholera, observed by Snow in 1854, to Koch’s discovery of the “mechanism of
action”, took 30 years of further scientific inquiry. Such a long time lag between
acknowledging compelling associations and understanding their mechanisms of action
is a common feature of scientific inquiry, as the histories of TBT, PCBs, DES, the
Great Lakes pollution, beef hormones and the other cases in the EEA report illustrate.

IV. KNOWLEDGE AND IGNORANCE REQUIRES BOTH PREVENTION
AND PRECAUTION

The Broad St. pump, TBT, DES, PCBs and Great Lakes Pollution examples described
here also serve to illustrate the contingent nature of knowledge. Today’s scientific
certainties can be tomorrow’s mistakes, and today’s research can both reduce and
increase scientific uncertainties, as the boundaries of the “known” and the unknown
expand. Waiting for the results of more research before taking action to reduce
threatening exposures may not only take decades but the new knowledge may identify
previously unknown sources of both uncertainty and ignorance, as awareness of what
we do not know expands, thereby supplying further reasons for inaction. “Paralysis by
Analysis “ can then follow.

“The more we know, the more we realise what we don’t know” is not an uncommon
scientific experience. Socrates observed some time ago:
“I am the wisest man alive, for I know one thing, and that is that I know nothing”.
(Plato’s Apology 1.21).

This was an early lesson in humility that has been lately forgotten by many scientists
and politicians, who often put what turns out to be “misplaced certainty” in today’s
scientific knowledge: or assume that uncertainty can only be reduced, and not
increased, by further research.
The distinction between uncertainty and ignorance is important. (Stirling, 1999)
Ignorance is knowing that today’s knowledge is very limited: it is the source of
scientific surprises, such as the hole in the ozone layer, the mesothelioma cancer from
asbestos, imposex in sea snails etc. It is distinct from the uncertainties that arise from
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gaps in knowledge and from variances in sampling and monitoring; parameter
variability; model assumptions; and from the other attempts to approximate, model
and predict unfolding realities.
Foreseeing and preventing hazards in the context of ignorance presents particular
challenges to decision-makers. At first sight it looks impossible to do anything to
avoid or mitigate “surprises”. And ignorance ensures that there will always be
surprises. However, some measures that could help limit the consequences of
ignorance and the impacts of surprises are:

• using intrinsic properties as generic predictors for unknown but possible
impacts e.g. the persistence, bioaccumulation and spatial range potential of
chemical substances. (Stroebe et al., 2004)
• reducing specific exposures to potentially harmful agents on the basis of
credible ‘early warnings’ of initial harmful impacts, thus limiting the size of
any other ‘surprise’ impacts from the same agent, such as the asbestos cancers
that followed asbestosis; and the PCB neurotoxicological effects that followed
its wildlife impacts.
• promoting a diversity of robust and adaptable technological and social options
to meet needs, which limits technological ‘monopolies’ (such as those like
asbestos, CFCs, PCBs etc.), and therefore reduces the scale of any ‘surprise’
from any one technological option.
• using more long-term research and monitoring of what appear to be “surprise
sensitive sentinels”, such as frogs and foetuses.

A. Prevention and Precaution
The distinction between prevention and precaution is also important. Preventing
hazards from “known” risks is relatively easy and does not require precaution.
Banning smoking, or asbestos, today requires only acts of prevention to avoid the
well-known risks. However, it would have needed precaution, (or foresight, based on
a sufficiency of evidence), to have justified acts to avoid exposure to the then
uncertain hazards of asbestos in the 1930s –50s, or of tobacco smoke in the 1960’s).
Such precautionary acts then, if implemented successfully, would have saved many
more lives in Europe than today’s bans on asbestos and smoking are doing. As
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Cogliano has recently pointed out, the difference between prevention and precaution
can be further illustrated by showing that prevention is used to justify the restriction
of exposure to an IARC Category 1 carcinogen whereas precaution is necessary to
justify restricting exposure to a Category 2A or B carcinogen, where the evidence is
less strong. The section below. on different levels of proof , further elaborates this
point.
For EMF, the question is, does the existing strength of evidence justify precautionary
actions now? Or will exposure reduction be delayed until the evidence is clear
enough to justify the more belated and overall less protective prevention of “known”
causes, so that EMF replicates the fate of asbestos ,smoking and most of the other
cases in the EEA report?

Some commentators, who have a long and distinguished history in preventing
occupational and environmental risks, have queried the added value of the
precautionary principle in the field of public health, with its long traditions of
prevention. (Goldstein, 2007).

The key to understanding the added value of the PP requires a) acknowledging the
distinction between prevention and precaution described above; b) an appreciation of
the further distinctions between the primary, secondary and tertiary preventative
measures that have long between adopted in public health, and the prior justification
for any such measure, which the PP brings; and c) a recognition of the increased
legitimacy and transparency that arises from the articulation and adoption of the PP
in legal texts, international agreements and conventions, as opposed to being merely
part of general practice.

More empirically, the evidence that many scientific disciples, legal scholars (de
Sadeleer, 2007),and international policymakers, have, since the 1970s, recognised
the need for legitimising the PP as a new policy tool that is better able to deal with
systems complexities, ignorance and uncertainties, suggests that the PP brings added
value to the protection of the environment and the public.

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There is much discussion generated by the different meanings often attached to the
common terms “prevention”, “precaution”, “risk”, “uncertainty” and “ignorance”.
Table 1 attempts to clarify these so as to help reduce unnecessary argumentation.

Table 1: Clarification of Key Terms
Situation
State and dates of
“Nature of the justification for
knowledge
Action”
Risk
‘Known’ impacts; ‘known’
Prevention: action taken to reduce
probabilities e.g. asbestos
known hazards e.g. eliminate
exposure to asbestos dust
Uncertainty
‘Known’ impacts; ‘unknown’
Precautionary prevention: action
probabilities e.g. antibiotics in
taken to reduce exposure to
animal feed and associated
potential hazards
human resistance to those
antibiotics
Ignorance
‘Unknown’ impacts and
Precaution: action taken to
therefore ‘unknown’
anticipate, identify and reduce the
probabilities eg the
impact of ‘surprises’
‘surprises’ of

chlorofluorocarbons
(CFCs) pre 1974
Source: Reproduced, with amendment, from the Late Lessons Report, EEA 2001.


V. THE PRECAUTIONARY PRINCIPLE: DEFINITIONS AND
INTERRPRETATIONS

There are some relatively rare but successful acts of “precautionary prevention” in the
EEA report such as on cholera in1854, on TBT in France in the 1980s, and on CFCs
in the 1970s. Together with the many other examples of the failure to use the
precautionary principle in the other case studies (EEA, 2001), these illustrate the
wisdom of taking appropriate precautionary actions to avoid plausible and serious
threats to health or environments, especially when the impacts are irreversible and
likely to be much more costly to society than the precautionary measures.

Some commentators have stressed the need for policymakers to take account of the
foreseeable, or plausible, countervailing ( secondary) costs of otherwise genuine
precautionary attempts to protect the environment and health. (Rushton, 2007). This
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consideration of countervailing costs has long been recognised by the better
policymakers, even if it is difficult in practice to anticipate and account for all
consequences of actions. And of course there are the secondary benefits of
precautionary actions as well, which tend to be less stressed, such as the benefit of
reduced respiratory and cardiovascular disease from the reduced combustion of fossil
fuels: a large and early secondary benefit of that climate change measure.

The outcomes of some controversial actions based on the PP, such as the EU ban on
antibiotics as growth promoters, which is a Late Lessons case study, have since been
scrutinised, and have been considered sound ,or unsound, depending on the science
used and its interpretation by different interests. (Cox, 2007, Angulo et al., 2004).

Any policy effectiveness analysis of measures taken to deal with such multi-causal
and long term hazards as antibiotics as growth promoters is fraught with
methodological difficulties and is hampered by long latencies and complex biological
systems: untangling the causal impact of one stressor amongst many inter-dependent
ones is virtually impossible. The value of applying more probabilistic and value of
information data to such conundrums is recognised by many risk managers.
However, this cannot remove the need for scientific and political judgment about how
to take appropriate and proportionate action in the face of irreducible uncertainties,
ignorance and plausible hazards which could have serious, widespread and
irreversible impacts and for which probabilities are not possible at the time when they
are most needed. This is the current case with many EMF exposures.


A. Some Definitions and Interpretations of the Precautionary Principle
The increasing awareness of complexity and uncertainty during the 1980/90’s led to
the German debates on the Vorsorgeprinzip shifting to the international level, initially
in the field of conservation (World Charter for Nature UN 1982), but then particularly
in marine pollution, where an overload of data accompanied an insufficiency of
knowledge. (Marine Pollution Bulletin, 1997). This generated the need to act with
precaution to reduce the large amounts of chemical pollution entering the North Sea.
Since then many international treaties have included the PP (including the often cited
version from the Third North Sea Ministerial Conference, 1990, have included
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reference to the precautionary principle, or, as they refer to it in the USA, the
precautionary approach.
The N.Sea declaration called for “action to avoid potentially damaging impacts of
substances, even where there is no scientific evidence to prove a causal link between
emissions and effects”.
This definition has often, and sometimes mischievously, been used to deride the
precautionary principle by claims that it appears to justify action even when there is
“no scientific evidence” that associates exposures with effects. However, the N. Sea
Conference definition clearly links the words “no scientific evidence” with the words.
“to prove a causal link”. We have already seen with the Broad St. pump and TBT
examples that there is a significant difference between evidence about an
“association” and evidence that is robust enough to establish a “causal” link. (Hill,
1965).

The Treaty of the European Union also cites the precautionary principle, as well as
the other key principles of sound public policy on health:
“Community policy on the environment … shall be based on the precautionary
principle and on the principles that preventive action should be taken, that
environmental damage should, as a priority, be rectified at the source and the
polluter should pay” (Treaty on European Union, 1992).

Other parts of the EU Treaty ,and cases taken at the European Court of Justice, make it clear
that these principles also apply to environmental and consumer protection issues.

These principles, as well as the important and legally required proportionality
principle, which limits disproportion between the costs and benefits of prevention, are
not defined in the Treaty but are illuminated by their practical application in case law.
However, all serious applications of the precautionary principle require some
scientific evidence of a plausible association between exposures and current, or
potential, impacts.
There is still much disagreement and discussion about the interpretation and practical
application of the precautionary principle, due, in part, to this lack of clarity and
consistency over its definition. For example, many definitions in the Treaties and
Conventions use a double negative to define the precautionary principle: that is, they
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