This chapter examines the practice of the European Court of Human Rights (ECtHR), the Inter-American Court of Human Rights (IACtHR), the African Court of Human and Peoples’ Rights (ACtHRP) and that of the ECOWAS Court. The analysis centers on comparable cases from their jurisprudence, where human rights claims have been filed due to health injuries allegedly caused by toxic exposure. The chapter addresses inter alia the role of the precautionary principle as a framing technique, applicable causal inquiries, the evidentiary practice of these fora and their deferential standards of review. It extensively criticizes the causal inquiry of the ECtHR, where causal links between toxic emissions and health injuries are apparently assessed based on non-scientific, intuitive proxies. From IACtHR jurisprudence the Human Rights and the Environment Advisory Opinion will also be discussed with respect to the causality-based jurisdiction the court announced.