Whilst obviously one would wish to be able to base every decision, action
and policy on scientific evidence, given the complexities of the human being
and the way it reacts to the many factors that impinge on it in everyday
life, will this ever be a possibility?

How many GPs practice their own medicine purely on the basis of scientific
studies? In my experience the good GP combines a blend of knowledge of the
science with his experience of what really works, plus his knowledge of the
patient and the patient's personality.

If, as someone who is concerned specifically with the prevention of damage
to health from workplace skin exposure, I were to base my actions purely on
scientific evidence, then there would be many situations in workplaces where
I would have to decline to assist the client, purely because the evidence
was not there. Since we lack "evidence" on exactly how many chemicals affect
the skin, how skin absorption and penetration occurs, why some people become
sensitised whilst others do not, etc., etc., should I wait until this
evidence is available before attempting to assist clients to prevent damage
to health of their workers?

Of course, in the article the definition of the word "evidence" seems to be
restricted to scientific, peer-reviewed studies published in the relevant
learned journals. I contend that there is a wider definition of the work
"evidence". My dictionary has two definitions:
1. The data on which a judgment or conclusion may be based or by which proof
or probability may be established, and 2. That which serves to indicate or
suggest.

Finally, I suggest that most occupational health nurses are far too busy
trying to achieve real results to have the time - or the funding and
facilities - to become involved in the type of scientific projects that are
proposed.

This is not to say that I am trying to play down the significance of
scientific research of this type, merely to claim that it is only one part
of the whole picture and that what is needed is a blend of the scientific
and the practical.

Chris

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