A couple of decades ago, controversy arose over the risk that bisphenol A—a chemical known as BPA—involved in health. This substance is widely used in the production of plastics and resins, and began to be used in the manufacture of pacifiers and accessories for girls and boys. In toxicological studies carried out under controlled conditions with laboratory animals, this compound was characterized as an endocrine disruptor, that is, a substance that affects the metabolism of various hormones and thus neurodevelopment, immunity and the potential onset of cancers. However, in epidemiological studies in population groups of humans, causal evidence on the relationship between BPA and the above-mentioned effects was not conclusive, meaning that these studies did not generate the same evidence as that obtained in the laboratory. Uncertainty about the BPA’s risk to the health of children urged several countries to ban its use in the development of children’s accessories, while others have waited for the evidence to be conclusive.
What happens when scientific evidence is not a recipe that we apply and that always gives us the same result? There are many examples in environmental health where epidemiological evidence is inconclusive, as was the case with BPA, and that make decision-making require a public health-based approach. Situations such as the BPA allow us to recognize the precautionary principle as an approach that responds to uncertainty with preventive measures to reduce potential negative effects on the population; therefore, this principle motivates us to interpret the lack of evidence as risk and not as a lack of causation. Given this premise, it seems necessary to reflect on what our position as a country will be to deal with acute events such as the current coronavirus pandemic, or more chronic states, such as the crisis of inequity that has progressed in recent decades.
Under the current scenario of the PANdemic for COVID19 — the coronavirus disease — and the rapid increase in incidence in regions such as the Metropolitan and the Magellan region, it is relevant to take a precautionary stance regarding the role that air pollution will play in health indicators such as incidence or lethality. In recent weeks, air quality has been good in some cities, however, the low temperatures experienced in southern country cities will mean greater energy demand and thus greater air pollution, and in some cases, increased intradomymiciliary pollution. Indeed, if we review the data of the air monitoring stations – belonging to the National Air Quality Information System, SINCA – in cities such as Osorno, Puerto Montt and Coyhaique, environmental alert and pre-emergence is already indicated.
Taking into account the precautionary principle, quarantine and isolation measures should be supplemented with short-term environmental measures— such as air quality monitoring and compliance monitoring — and in the medium and long term — such as the transition to an energy matrix consistent with the current scenario. Evidence on airborne transmission of the virus may take time to build; However, we already know that air pollution increases diseases and deaths from respiratory, cardiovascular and cancers, particularly affecting people who experience some form of vulnerability such as basal diseases or disadvantaged social conditions, and that increases the incidence of influenza-type infections, i.e. COVID19-like cases.
Although social media and the media have stressed that measures such as quarantine are having a positive effect on air quality, it is also true that this effect is temporary and probably not significant. Therefore, this pandemic represents a challenge that fuels the fantasy that we all have access to health, that is, that the protection of physical, mental and social well-being, and not just the absence of disease, is an indisputable right for all members of our society. In order for this fantasy to become a reality and to overcome the crisis in an equitable manner, it is necessary to establish the idea that the precautionary principle is not only an approach based on a philosophical stance, but is one of the principles fundamentals of the new social compact that is required to solve the chronic problems we have of the past and to better address the current and future challenges that the anthropoccenus era brings with it.
The content poured into this opinion column is the sole responsibility of its author, and does not necessarily reflect the editorial line or position of El Mostrador.
