The Precautionary Principle
I had a phone call this morning by my local radio station
asking if I would go on air to discuss the newly released Royal College of
Obstetricians and Gynaecologists
(RCOG) Scientific Impact Paper: Chemical
Exposures During Pregnancy: Dealing with Potential, but Unproven, Risks to
Child Health. I agreed and the
interview can be heard about 9.5 minutes in here for the next 7 days.
Media Hype
A quick look at the headlines showed a huge amount of criticism
of the paper, some calling it Alarmist and confusing . Don't buy furniture when pregnant, don't use plastic in food containers, paint etc. etc. However, a read of the actual paper rather than the media headlines convinced me that it was worth exploring. 'It is being increasingly recognized that predisposition to some adult health disorders is determined by the quality of the baby's development in the womb and soon after birth'. Chemicals have the potential to interfere with hormone systems...this is common knowledge these days. We know mums are the gatekeepers or guardians of the baby's environment. While this seems like and is a huge and scarey responsibility, it is also an opportunity to give our children the very best start possible. Simple suggestions are made: eat more fresh food, less processed and packaged products, reduce exposure to paint and pesticides, use cosmetics and over the counter medicines with caution.
Easier said than done?
In our modern world all of us are bombarded by a complex mixture of hundreds of chemicals in small doses. Some of these chemicals have been linked by Epidemiological research with adverse birth outcomes including pregnancy loss. 'Linked'...this is important as it is very very difficult to tease out single chemicals which 'cause' problems. It is far more likely that it is the cocktail combinations and continual exposure to numerous substances that can cause a problem in some people.
Assessing the full risk of exposure may be impossible.
This paper argues that 'methods for assessing the full risk of exposure are not yet developed'. On present evidence it is impossible to assess the risk, if any, of cumulative exposure to many chemicals. So if it's not 'proven' to harm with hard evidence, it must be OK we assume? Not me.
Chemical regulation will protect us right? Wrong
If there is no 'proof' that perfumed shower gel causes harm does that mean we shouldn't worry? The
current
philosophical underpinning of chemical regulation in most countries is
such that substantial evidence of harm is required before regulatory
action is taken. Also regulations do not require low dose usage of potentially harmful chemicals to be named on the product label. If the use of terms such as 'natural' and 'non-toxic' are not regulated and they come in a pretty 'green' package, how are we supposed to tell what is safe? A wise client once told me you should never put anything on your skin that you wouldn't eat. We forget that the skin is very good at absorption.
The Precautionary Principle
The Precautionary Principle asks what potential costs or benefits could arise from the adoption of a more precautionary approach in circumstances where lack of full scientific certainty exists in chemical assessment or control of use. When addressing the use of new and man made chemicals I believe action should be taken to prevent harm to the environment and human health, even if scientific proof is inconclusive. This is especially true of our most vulnerable groups such as pregnant women and babies/children.
Empowerment?
It is impossible to have a risk free pregnancy. Midwifery is about being with women and families to navigate the choices and information out there. If a client asks me 'Is it safe to use haircolour when I'm pregnant' I have to answer 'I don't know' this is the only truthful answer. Am I trying to scare her? Should I just reassure her and say it's fine? The evidence isn't clear, that's what I have to say. All of us want to minimize the risks while living in the real world. This Scientific impact paper addresses some of the uncertainties. It is not research, it is not even strong advice. It just highlights the potential, unproven risks and how to minimise them. It is long overdue.
