Implications of the precautionary principle for primary prevention and research.

The precautionary principle (PP) is an extension of the public health presage that prevention is better than cure. The PP has recently achieved new relevance in regard to serious but uncertain threats to human health and the environment and has now entered national and international legislation. However, frameworks for its unambiguous application in practice are yet to be designed. They will depend on legal and cultural circumstances and are likely to involve pluralities of perspectives and stakeholder participation. The rules for causal reasoning and dose dependence need to be addressed and may be conveniently expressed in accordance with probability theory. Although the PP will allow action before convincing evidence is secured, it is not science averse. However, it provides an occasion to review environmental health research strategies, methodologies, and research-reporting traditions. From this perspective, current research is afflicted by important biases and insufficient focus on major environmental health problems.