title: On the even greater need for precaution under global change.
abstract: 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 the 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.
authors.affiliation: Department of Public Health Sciences, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada. colin.soskolne@ualberta.ca
authors.forename: Colin L
authors.initials: CL
authors.lastname: Soskolne
mesh_terms: D002170:Canada; D017753:Ecosystem; D004781:Environmental Exposure / Q000009:adverse effects / Q000517:prevention & control*; D004782:Environmental Health; D014943:Global Health; D017408:Guidelines as Topic; D006304:Health Status; D006801:Humans; D020380:Needs Assessment; D011322:Primary Prevention / Q000458:organization & administration*; D011634:Public Health; D035501:Uncertainty