Transparent democratic foresight strategies in the California EMF Program

Evidence maps: communicating risk assessments in societal controversies: the case of engineered nanoparticles

The transparent and fair characterization of scientific evidence for reporting the results of a hazard assessment is a demanding task. In this article, we present an approach for characterizing evidence--the evidence map approach. The theoretical starting point is to view evidence characterization as a form of argumentation. Thus, evidence maps are designed to depict the evidence base, the pro and con arguments, and the remaining uncertainties, which together lead experts to their conclusions when summarizing and evaluating the scientific evidence about a potential hazard. To illustrate its use, the evidence maps approach is applied to characterizing the health-relevant effects of engineered nanoparticles. Empirical data from an online survey suggests that the use of evidence maps improves the reporting of hazard assessments. Nonexperts prefer to receive the information included in an evidence map in order to come to an informed judgment. Furthermore, the benefits and limitations of evidence maps are discussed in the light of recent literature on risk communication. Finally, the article underlines the need for further research in order to increase quality of evidence reporting.

Evaluating emerging issues in epidemiology

Industry and government institutions need a credible approach for evaluating and responding to emerging public health issues. Representatives of industry, government, and academia met under the auspices of the International Life Sciences Institute's Health and Environmental Sciences Institute (HESI) to develop successful strategies for dealing with emerging issues based on historical case studies. The case studies chosen for evaluation were (1) tampon use and toxic shock syndrome; (2) hazardous waste and childhood cancer risk in Toms River, New Jersey; (3) fenfluramine and phentermine use and valvular heart disease; (4) silicone breast implants and cancer and auto-immune disease; and (5) progestational drugs and birth defects. We identified eight lessons from these case studies. Foremost, we recommend that public and private institutions not defer action until an issue is scientifically resolved and stress that cooperation among issue stakeholders is critical for effective issue resolution. We suggest establishing a research program as an effective way to assure that good science is included in resolution of the issue. We further recommend frequent and timely communication with all stakeholders, and the development of research approaches to fill gaps when the scientific data on an issue are limited.

What Does the Precautionary Principle Mean for Evidence-Based Dentistry?

The precautionary principle calls for preventive actions in the face of uncertain information about risks. It serves as a compass to better guide more health-protective decisions in the face of complex risks. Applying precaution requires thinking more broadly about risks, taking an interdisciplinary approach to science and policy, and considering a wide range of alternatives to potentially harmful activities. While often criticized as antiscientific, the precautionary principle represents a challenge to scientists and public health professionals to develop newer and more effective tools for characterizing and preventing complex risks, in addition to being more explicit about uncertainties. This article examines the role and application of precaution in the context of dental practice, where activities that may convey risks also have public health benefits, and risk trade offs are a possibility. We conclude that the precautionary principle is not at odds with, but rather complements evidence-based practice in situations of scientific uncertainty and complex risks.