IN DUBIO PRO NATURA? A Philosophical Analysis of the Precautionary Principle in Environmental and Health Risk Governance

In this book, I apply a philosophical approach to study the precautionary principle in environmental (and health) risk decision-making. The principle says that unacceptable environmental and health risks should be anticipated, and they ought to be forestalled before the damage comes to fruition even if scientific understanding of the risks is inadequate. The study consists of introductory chapters, summary and seven original publications which aim at explicating the principle, critically analysing the debate on the principle, and constructing a basis for the well-founded use of the principle. Papers I-V present the main thesis of this research. In the two last papers, the discussion is widened to new directions. The starting question is how well the currently embraced precautionary principle stands up to critical philosophical scrutiny. The approach employed is analytical: mainly conceptual, argumentative and ethical. The study draws upon Anglo-American style philosophy on the one hand, and upon sources of law as well as concrete cases and decision-making practices at the European Union level and in its member countries on the other. The framework is environmental (and health) risk governance, including the related law and policy. The main thesis of this study is that the debate on the precautionary principle needs to be shifted from the question of whether the principle (or its weak or strong interpretation) is well-grounded in general to questions about the theoretical plausibility and ethical and socio-political justifiability of specific understandings of the principle. The real picture of the precautionary principle is more complex than that found (i.e. presumed) in much of the current academic, political and public debate surrounding it. While certain presumptions and interpretations of the principle are found to be sound, others are theoretically flawed or include serious practical problems. The analysis discloses conceptual and ethical presumptions and elementary understandings of the precautionary principle, critically assesses current practices invoked in the name of the precautionary principle and public participation, and seeks to build bridges between precaution, engagement and philosophical ethics. Hence, it is intended to provide a sound basis upon which subsequent academic scrutiny can build.

Kuluttajien ja asiantuntijoiden kokemat elintarvikkeiden terveysriskit

Summary: Consumers' and scientists' perceptions of food-related health risks

Riskien arviointi ja turvallisuusjohtaminen

Yrityksen työturvallisuus- ja työterveysriskien arvioiminen on lakisääteinen velvollisuus. Myös turvallisuusjohtamiseen lainsäädäntö kohdistaa yhä tiukempia velvotteita. Sicpa Oy:n Tampereen tuotantolaitoksella tehtiin riskien arviointi käyttäen Sosiaali- ja terveysministeriön riskien arviointimenetelmää. Riskien arvioinnin tuloksia käytettiin laadittaessa Sicpa Oy:n turvallisuusjohtamisjärjestelmän suuntaviivoja OHSAS 18001 -standardin mukaisesti. Riskien arvioinnissa tapaturman vaaroja löytyi lukumääräisesti eniten. Kuitenkin kemikaalien aiheuttamat vaarat koettiin riskin suuruuden määrityksessä tärkeimmiksi. Kemikaaliriskien tärkeyttä korostaa myös se, että juuri niiden tuntemuksessa oli puutteita.

Puhdistetun jäteveden patogeenit ja desinfiointitarve

Turun seudulla kuuden kunnan jätevesien käsittely keskitetään Kakolanmäen kallion sisälle rakennettuun jätevedenpuhdistamoon, joka otetaan käyttöön vuoden 2008 lopulla. Kakolanmäen jätevedenpuhdistamolla on varauduttu tulevaisuudessa kiristyviin lupaehtoihin sekä mahdollisiin puhdistetun jäteveden hygieenistä laatua koskeviin lisämääräyksiin jättämällä tilavaraus puhdistetun jäteveden desinfioimiselle ultraviolettivalolla. Diplomityössä on selvitetty vuoden kestäneessä tutkimusjaksossa 1.9.2006- 31.8.2007 Turun kaupungin keskuspuhdistamolta mereen johdetun puhdistetun jäteveden ja esiselkeytetyn ohitusveden hygieenisen laadun vaihtelua. Jäteveden desinfiointitarvetta on arvioitu tarkastelemalla jätevedenpuhdistamon hygieenistä puhdistustulosta ja jätevesien vaikutusta purkuvesistön hygieeniseen tilaan. Tutkimuksen perusteella virtaama ei vaikuttanut merkittävästi jäteveden ulosteperäisten bakteerien määriin. Sen sijaan jäteveden bakteeripitoisuudet laskivat alhaisissa lämpötiloissa. Lämpötilan vaikutus näkyi selkeämmin esiselkeytetyssä kuin puhdistetussa jätevedessä eli bakteerien poistumiseen aktiivilietevaiheen aikana vaikuttavat muut tekijät. Mitä tehokkaammin aktiivilietevaihe toimi, sitä tehokkaammin myös bakteereja poistui. Taudinaiheuttajabakteerit selvisivät puhdistusprosessista paremmin viileän kauden aikana. Puhdistetun jäteveden hygieeninen laatu ei täyttänyt uimaveden tai kasteluveden laatuvaatimuksia, joten desinfiointitarve olisi perustelua. Jätevesien vaikutus Turun edustan merialueen hygieeniseen tilaan näkyi ajoittain korkeina bakteeripitoisuuksina purkupaikan lähistöllä. Vielä ei ole suoraa näyttöä siitä aiheuttavatko jätevedet purkupaikan lähistön uimarannoilla terveydellisiä riskejä. Jäteveden UV-desinfiointi kannattava toteuttaa vain jos hygieeninen puhdistusvelvoite määrätään. UV-desinfioinnin mitoituksessa Kakolanmäen jätevedenpuhdistamolla tulee ottaa huomioon suurin sallittu hydraulinen painehäviö. Mitoitus voidaan tehdä puhdistamon käyttöönoton jälkeen kun tarvitut prosessimittaustiedot ovat saatavilla.

Juvan kunnan jätevedenpuhdistamon ympäristöasioiden parantaminen

Diplomityö on osa Mikkelin ammattikorkeakoulun YTI:ssä vuosina 2005 - 2008 toteutettua ”Yritysten ympäristöriskit” EU-osarahoitteista hanketta. Työn tarkoituksena oli tunnistaa, arvioida ja luokittaa Etelä-Savossa, Juvalla toimivan yhdyskuntajätevedenpuhdistamon ympäristöriskit sekä antaa neuvoja löytyneiden riskien hallintaan. Jätevedenpuhdistamon toiminnasta syntyvät mahdolliset ympäristöriskitekijät tunnistettiin kirjallisuusselvitysten sekä haastattelujen avulla. Riskien tunnistamisen jälkeen riskien kartoittamiseen, arviointiin ja luokittamiseen käytettiin osia eri riskianalyysimenetelmistä. Riskit jaettiin viiteen eri riskiluokkaan; vakavasta riskistä merkityksettömään riskiin. Juvan kunnan jätevedenpuhdistamolla esiintyi neljän pienimmän riskiluokan riskejä, ja vakavia riskejä ei kartoituksessa tullut esille lainkaan. Riskejä arvioitiin niin sanotuissa normaalioloissa. Merkittävin yksittäinen riskitekijä jätevedenpuhdistamolla oli haitallisen tai poikkeavan aineen kulkeutuminen jäteveden mukana puhdistamolle. Tämä voisi heikentää puhdistamon puhdistustulosta merkittävästi. Kun laitosta ajetaan ympäristöluvassa asetettujen vaatimusten mukaisesti ja alueella sijaitsevat teollisuuslaitokset noudattavat heille annettuja määräyksiä, ei Juvan jätevedenpuhdistamolta aiheudu merkittäviä päästöjä maa-perään tai pohjavesiin.

Persistent organic pollutants in sediments and fish from Lake Victoria, Uganda

This thesis describes the occurrence and sources of selected persistent organic pollutants (POPs) such as polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and hexachlorocyclohexanes (HCHs) in the northern watershed of Lake Victoria. Sediments and fish were collected from three highly polluted embayments (i.e. Murchison Bay, Napoleon Gulf and Thurston Bay) of the lake. The analysis for PCDD/Fs, PCBs and PBDEs was done using a high resolution mass spectrometer coupled to a gas chromatograph (GC), and a GC equipped with an electron capture detector was used for HCHs. Total (Σ) PCDD/Fs, PCBs and PBDEs in sediments ranged from 3.19 to 478, 313 to 4325 and 60.8 to 179 pg g-1 dry weight (dw), respectively. The highest concentrations of pollutants were found at sites close to industrial areas and wastewater discharge points. The maximum concentrations of PCDD/Fs, PCBs, PBDEs and HCHs in fish muscle homogenates were 49, 779, 495 and 45,900 pg g-1 wet weight (ww), respectively. The concentrations of the pollutants in Nile perch (Lates niloticus) were significantly greater than those in Nile tilapia (Oreochromis niloticus), possibly due to differences in trophic level and dietary feeding habits among fish species. World Health Organization-toxic equivalency quotient (WHO2005-TEQ) values in the sediments were up to 4.24 pg g-1 dw for PCDD/Fs and 0.55 pg TEQ g-1 dw for the 12 dioxin-like PCBs (dl-PCBs). 23.1% of the samples from the Napoleon Gulf were above the interim sediment quality guideline value of 0.85 pg WHO-TEQ g-1 dw set by the Canadian Council for Ministers of the Environment. The WHO2005-TEQs in fish were 0.001-0.16 pg g-1 for PCDD/Fs and 0.001-0.31 pg g-1 ww for dl- PCBs. The TEQ values were within a permissible level of 3.5 pg g−1 ww recommended by the European Commission. Based on the Commission set TEQs and minimum risk level criteria formulated by the Agency for Toxic Substances and Disease Registry, the consumption of fish from Lake Victoria gives no indication of health risks associated to PCDD/Fs and PCBs. Principal component analysis (PCA) indicated that anthropogenic activities such as agricultural straw open burning, medical waste incinerators and municipal solid waste combustors were the major sources of PCDD/Fs in the watershed of Lake Victoria. The ratios of α-/γ-HCH varied from 0.89 to 1.68 suggesting that the highest HCH residues mainly came from earlier usage and fresh γ-HCH (lindane). In the present study, the concentration of POPs in fish were not significantly related to those in sediments, and the biota sediment accumulation factor (BSAF) concept was found to be a poor predictor of the bioavailability and bioaccumulation of environmental pollutants.

Quantification of Toxin Biosynthesis Genes In Cyanobacteria and Dinoflagellates - Genetic Factors as Predictors of Toxin Production in the Environment

Harmful algal blooms (HABs) are events caused by the massive proliferation of microscopic, often photosynthetic organisms that inhabit both fresh and marine waters. Although HABs are essentially a natural phenomenon, they now cause worldwide concern. Recent anthropogenic effects, such as climate change and eutrophication via nutrient runoff, can be seen in their increased prevalence and severity. Cyanobacteria and dinoflagellates are often the causative organisms of HABs. In addition to adverse effects caused by the sheer biomass, certain species produce highly potent toxic compounds: hepatotoxic microcystins are produced exclusively by cyanobacteria and neurotoxic saxitoxins, also known as paralytic shellfish toxins (PSTs), by both cyanobacteria and dinoflagellates. Specific biosynthetic genes in the cyanobacterial genomes direct the production of microcystin and paralytic shellfish toxins. Recently also the first paralytic shellfish toxin gene sequences from dinoflagellate genomes have been elucidated. The public health risks presented by HABs are evident, but the monitoring and prediction of toxic events is challenging. Characterization of the genetic background of toxin biosynthesis, including that of microcystins and paralytic shellfish toxins, has made it possible to develop highly sensitive molecular tools which have shown promise in the monitoring and study of potentially toxic microalgae. In this doctoral work, toxin-specific genes were targeted in the developed PCR and qPCR assays for the detection and quantification of potentially toxic cyanobacteria and dinoflagellates in the environment. The correlation between the copy numbers of the toxin biosynthesis genes and toxin production were investigated to assess whether the developed methods could be used to predict toxin concentrations. The nature of the correlation between gene copy numbers and amount of toxin produced varied depending on the targeted gene and the producing organism. The combined mcyB copy numbers of three potentially microcystin-producing cyanobacterial genera showed significant positive correlation to the observed total toxin production. However, the presence of PST-specific sxtA, sxtG, and sxtB genes of cyanobacterial origin was found to be a poor predictor of toxin production in the studied area. Conversely, the dinoflagellate sxtA4 was a good qualitative indicator of a neurotoxic bloom both in the laboratory and in the field, and population densities reflected well the observed toxin concentrations. In conclusion, although the specificity of each potential targeted toxin biosynthesis gene must be assessed individually during method development, the results obtained in this doctoral study support the use of quantitative PCR -based approaches in the monitoring of toxic cyanobacteria and dinoflagellates.

Sähkösuodattimen mahdollisuudet sisäilman parantajana

Diplomityön tavoitteena oli selvittää, kuinka sähkösuodattimella voidaan vaikuttaa sisäilman laatuun ja kuinka kilpailukykyinen vaihtoehto pienkiinteistöissä sähkösuodatin on perinteisiin kuitusuodattimiin verrattuna. Teoriaosassa tarkasteltiin, kuinka ilman hengitettävät hiukkaset muodostuvat ja miten ne vaikuttavat sisäilman laatuun sekä ihmisten terveyteen. Tarkasteltiin hiukkasten koon, lukumäärän, massan ja pinta-alan yhteyksiä niiden terveysvaikutuksiin. Ultrapienet hiukkaset ovat terveydelle haitallisimpia, koska hiukkasten lukumäärä ja pinta-ala lisäävät terveyshaittoja enemmän kuin hiukkasten massa. Tutkittiin pienkiinteistöjen ilmanvaihtoratkaisuja ja erilaisia tuloilmanpuhdistus-menetelmiä. Soveltavassa osassa tarkasteltiin sähkösuodattimen toimintaa ja sen mahdollisuuksia sisäilman parantajana verrattuna perinteisiin kuitusuodattimiin. Tehtiin sähkösuodattimen ja kuitusuodattimen välinen elinkaarikustannusvertailu keskisuurelle omakotitalolle. Kirjallisuuden ja tutkimushavaintojen perusteella sähkösuodattimen suurin etu muihin suodattimiin verrattuna on sen kyky poistaa kaiken kokoisia, myös ultrapieniä, hengitettäviä hiukkasia ja siten tehokkaasti vähentää hengitettävien hiukkasten lukumäärää ja pinta-alaa. Tällä voi olla vaikutusta yleisten terveyshaittojen ja ympäristöherkkyyden ennaltaehkäisemisessä. Ympäristöherkkyyteen sairastuneiden oireiluun sähkösuodatin voi tuottaa helpotusta kotioloissa ja siirrettävän ilmanpuhdistimen avulla myös työpaikoilla. Elinkaarikustannusvertailun perusteella selvisi, että sähkösuodatin on kalliimmasta hinnastaan huolimatta kokonaiskustannuksiltaan selvästi edullisempi vaihtoehto kuin kuitusuodattimet. Sähkösuodattimen haasteena on uuden teknologian lanseeraaminen pientalorakentamiseen. Pienrakennusten tuloilman puhdistusmenetelmien kehittämisellä olisi mahdollista parantaa suomalaisten elämänlaatua ja saavuttaa merkittäviä säästöjä terveydenhoitokuluissa.

Machine Learning and Clinical Text. Supporting Health Information Flow

Fluent health information flow is critical for clinical decision-making. However, a considerable part of this information is free-form text and inabilities to utilize it create risks to patient safety and cost-­effective hospital administration. Methods for automated processing of clinical text are emerging. The aim in this doctoral dissertation is to study machine learning and clinical text in order to support health information flow.First, by analyzing the content of authentic patient records, the aim is to specify clinical needs in order to guide the development of machine learning applications.The contributions are a model of the ideal information flow,a model of the problems and challenges in reality, and a road map for the technology development. Second, by developing applications for practical cases,the aim is to concretize ways to support health information flow. Altogether five machine learning applications for three practical cases are described: The first two applications are binary classification and regression related to the practical case of topic labeling and relevance ranking.The third and fourth application are supervised and unsupervised multi-class classification for the practical case of topic segmentation and labeling.These four applications are tested with Finnish intensive care patient records.The fifth application is multi-label classification for the practical task of diagnosis coding. It is tested with English radiology reports.The performance of all these applications is promising. Third, the aim is to study how the quality of machine learning applications can be reliably evaluated.The associations between performance evaluation measures and methods are addressed,and a new hold-out method is introduced.This method contributes not only to processing time but also to the evaluation diversity and quality. The main conclusion is that developing machine learning applications for text requires interdisciplinary, international collaboration. Practical cases are very different, and hence the development must begin from genuine user needs and domain expertise. The technological expertise must cover linguistics,machine learning, and information systems. Finally, the methods must be evaluated both statistically and through authentic user-feedback.

Sedentary behaviour and health with special reference to obesity and fatty liver in early midlife. The Cardiovascular risk in Young Finns Study

Background: Physical inactivity and positive energy balance pose a risk to health. They increase the risk of obesity and associated non-communicable diseases. Recently, also sedentary behaviour has been associated with obesity and non-communicable diseases. Nevertheless, it has been unclear which type of sedentary behaviour is the most harmful. It is also unknown whether the relationship of sedentary behaviour with obesity is truly independent of other factors, for example physical activity and diet. Longitudinal data are limited, and the direction of causality and the mechanism of action are still unknown. Aims: The aim of this study was 1) to identify the type of sedentary behaviour having the strongest association with obesity, 2) to explore the causal relationship of sedentary behaviour and weight increase, and 3) to additionally, investigate the relationship of sedentary behaviour with fatty liver. These were studied in cross-sectional and/or longitudinal settings using data from the Cardiovascular Risk in Young Finns Study. Special emphasis was put on the evaluation of a wide range of other lifestyle factors and risks for obesity and fatty liver. Subjects: 2,060 subjects (aged 33-50 years in 2011, of which 55 % were female) from the Cardiovascular Risk in Young Finns Study participating in follow-ups in 2001, 2007, and 2011. Measures: Self-reported time spent in various types of sedentary behaviour (I), or TV viewing time (I-III). Measured body weight, height and waist circumference (I-III), and genetic variants for high BMI (I). Fasting plasma concentrations of gamma-glutamyltransferase enzyme and triglyceride, calculated Fatty Liver Index (based on gamma-glutamyltransferase and triglyceride concentration, BMI and waist circumference), and the amount of intrahepatic fat measured with ultrasound (III). Self-reported leisure-time physical activity and active commuting, occupational physical activity, energy intake, diet, alcohol consumption, smoking, socioeconomic status, and sleep duration as possible confounders were considered (I-III). Results: TV viewing is the sedentary behaviour type that has the strongest association with obesity. Sedentary behaviour (TV viewing) precedes weight increase, and not the other way around. Sedentary behaviour (TV viewing) is associated with increased risk of fatty liver. Conclusions: Sedentary behaviour (especially high TV viewing time) is associated with increased risks of obesity and fatty liver. Intervention studies are needed to assess whether reduction of TV time would prevent obesity and fatty liver.