Hau Monica, Cole Donald, Vanderlinden Loren, MacFarlane Ronald, Mee Carol, Archbold Josephine, Campbell Monica
Int J Occup Environ Health. 2014 Apr-Jun;20(2):174-84. doi: 10.1179/2049396713Y.0000000051. Epub 2013 Dec 26.
The precautionary principle (PP) urges actions to prevent harm even in the face of scientific uncertainty. Members of Toronto Public Health (TPH) sought guidance on applying precaution.
We searched five bibliographic databases (yield 60 articles from 1996 to 2009 and 8 from 2009 to 2011) and Google (yield 11 gray literature sources) for material relevant to local public health. From these sources, we extracted questions until saturation was reached (n =55). We applied these questions retrospectively to eight case studies where TPH felt precaution was applied. We ranked questions for their importance in applying precaution.
Our final guide included 35 questions in five domains: context, assessment, alternative interventions, implementation, and monitoring and evaluation. Importance rankings varied across cases, but the role of stakeholders in driving precautionary action was consistent. Monitoring and evaluation components could have been strengthened across cases.
The TPH guide can assist municipal environmental health practitioners in applying precaution in a more transparent manner.
预防原则（PP）敦促采取行动预防危害，即便面对科学上的不确定性。多伦多公共卫生部门（TPH）的成员寻求关于应用预防措施的指导。
我们在五个文献数据库（1996年至2009年产出60篇文章，2009年至2011年产出8篇）以及谷歌（产出11个灰色文献来源）中搜索与当地公共卫生相关的资料。从这些来源中，我们提取问题直至达到饱和（n = 55）。我们将这些问题回顾性地应用于TPH认为应用了预防措施的八个案例研究。我们对问题在应用预防措施方面的重要性进行了排名。
我们的最终指南包括五个领域的35个问题：背景、评估、替代干预措施、实施以及监测与评估。重要性排名因案例而异，但利益相关者在推动预防行动中的作用是一致的。各案例中的监测与评估部分本可得到加强。
TPH指南可协助城市环境卫生从业者以更透明的方式应用预防措施。
