Occupational andEnvironmental Medicine

Editor: Anne Cockcroft

Technical Editor: Basil Haynes

EditonialAssistant: Rachel HarveyEditorial Board:

T C Aw

F J H Van Dijk

J S EvansR M Harrison

J Jevaratnam

F KauffmannR L MaynardR McNameeJ MyersB Nemery

T Okubo

P PaolettiL RosenstockM SimM Singal

D C Snashall

0 Svane

G TheriaultK M Venables

Editor, Bnrtish MedicalJournal

NOTI C1' T10C ONTIRiBUITORS OcciupatiOnal and 1-nvironmentialMedicine is intended for the publication of original contribu-tions relevant to occupational and environmental medicine,including toxicological studies of chemicals of industrial, agri-cultural, and environmental importance, and epidemiologicalstudies. As well as full papers, short papers dealing with bncfor preliminary observations relevant to occupational and envi-ronmental medicine will also be considered. Case reportsshould cover substantial new ground to merit publication.Other articles, including review or position papers, will be con-sidered but should not be submitted without first approachingthe Editor to discuss their suitability for the 7ournal. Letters tothe Editor are always welcome.

INS Rt'(.'ION'S I1'0 51 HOR.S ~Three copies of all submissionsshould be sent to: The Editor, Occuipationial aindItniironptientalMedCicine, BMJ Publishing Group, BMA House, TavistockSquare, I ondon WCl1H 9JR, UK. All authors should sign thecovering letter as evidence of consent to publication. Papersreporting results of studies on human subjects must be accom-panied by a statement that the subjects gave written, informedconsent and by evidence of approval from the appropriateethics committee. These papers should conform to theprinciples outlined in the Declaration of Helsinki (B.IAA1964;ii 177).

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Nethercott, Paustenbach, Adams, Fowler, Marks, Morton, Taylor, Horowitz, Finley

patients in Toronto, Canada. Contact Dermatitis 1982;8:389-95.

56 Bagdon RE. Dermal absorption of selected chemicalsunder experimental and human exposure conditions tofacilitate risk assessment and the development of standardsfor soil. Report to the Office of Science and Research,Trenton, New Jersey: New Jersey Department ofEnvironmental Protection & Energy (NJDEPE), 1989.

57 Nethercott JR. Practical problems in the use ofpatch testingin evaluation of patients with contact dermatitis. In:Weston W, ed. Current problems in dermatology, St Louis:Mosby-year Book Inc, 1990:101-23.

58 GENSTAT Reference Manual. GENSTAT 5, release 2.2.Oxford: Clarendon Press, 1982.

59 Rothman KJ. Modern epidemiology. Boston: Little, Brown,and Co 1987.

60 Armitage P, Berry G. Statistical methods in medical research.2nd ed. Oxford: Blackwell Scientific Publications.1987:485-6:495-6.

61 Paustenbach DJ, Sheehan PJ, Lau V, Meyer D. An assess-ment and quantitative uncertainty analysis of the healthrisks to workers exposed to chromium contaminatedsoils. Toxicol Ind Health 1991;7:159-96.

62 Weston WL, Weston JA. Allergic contact dermatitis inchildren. AmJIDis Child 1984;138:932-6.

63 Rudzki E, Rebandel P, Grzywa Z. Patch tests with occupa-tional contactants in nurses, doctors and dentists.Contact Dermatitis 1989;20:247-50.

64 Heskel NS. Contact dermatitis in children. Dermatol Clin1984;2:579-84.

65 Hjorth N. Contact dermatitis in children. Acta DermVenereol (Stockh) 1981;S95:36-9.

66 Schachner I, Ling NS, Press S. A statistical analysis of apediatric dermatology clinic. Pediatr Dermatol 1983;1:157-64.

67 Romaguera C, Alomar A, Camarasa JMG. Contact der-matitis in children. Contact Dermatitis 1985;12:283-4.

68 Tunnessen WW. A survey of skin disorders seen in pedi-atric general and dermatology clinics. Pediatr Dermatol1984;1:219-22.

69 Angelini G, Meneghini CL. Contact dermatitis inchildren. Pediatric Dermatology News 1987;6: 195-204.

70 Finley BL, Horowitz SB. Using human sweat to extractchromium from chromite-ore processing residue: appli-cations to setting health-based cleanup standards.Y Toxicol Environ Health 1993;40:585-99.

Vancouver styleAll manuscripts submitted to Occup EnvironMed should conform to the uniformrequirements for manuscripts submitted tobiomedical journals (known as theVancouver style.)

Occup Environ Med, together with manyother international biomedical journals, hasagreed to accept articles prepared in accor-dance with the Vancouver style. The style(described in full in the BMJ, 24 February1979, p 532) is intended to standardizerequirements for authors.

References should be numbered consec-utively in the order in which they are firstmentioned in the text by Arabic numeralsabove the line on each occasion the refer-ence is cited (Manson' confirmed otherreports . . .). In future references topapers submitted to Occup Environ Med

should include: the names of all authors ifthere are seven or less or, if there are more,the first six followed by et al; the title ofjournal articles or book chapters; the titlesof journals abbreviated according to thestyle of Index Medicus; and the first and finalpage numbers of the article or chapter.Titles not in Index Medicus should be givenin full.

Examples of common forms of refer-ences are:

1 International Steering Committee of Medical Editors,Uniform requirements for manuscripts submitted tobiomedical journals. BrMedJ 1979;1:532-5.

2 Soter NA, Wasserman SI, Austen KF. Cold urticaria:release into the circulation of histamine and eosino-phil chemotactic factor of anaphylaxis during coldchallenge. N EnglJ Med 1976;294:687-90.

3 Weinstein L, Swartz MN. Pathogenic properties ofinvading micro-organisms. In: Sodeman WA Jr,Sodeman WA, eds. Pathologic physiology, mechanismsof disease. Philadelphia: W B Saunders, 1974:457-72.

380

Wong, Trent, Whorton

We express our appreciation to the Styrene Information andResearch Center (SIRC) and its member companies for spon-

soring this study. Additionally, the staff at each of the 30plants participating in the study contributed valuable data toboth the original study and the update. We express our appre-ciation to the SIRC Epidemiology Committee for valuablesuggestions and comments, and to the staff at ENSR (espe-cially Rosanna Hollie and Melissa Hays) for technical andadministrative support. We also thank the staff at the NationalDeath Index and state health departments for providing deathcertificate information.

1 Preston RJ. The potential mutagenicity of styrene and itsmetabolites. SIRC Review 1990;1:25-31.

2 Anwar WA, Shamy MY. Cytogenetic and biomedicalchanges in workers exposed to styrene. [abstract].International symposium on health hazards of butadiene andstyrene. Espoo, Finland, 18-21 April, 1993.

3 Scott D. Cytogenetic studies of workers exposed tostyrene: A review. [abstract]. International symposium on

health hazards of butadiene and styrene. Espoo, Finland,18-21 April, 1993.

4 Wong 0. A cohort mortality study and a case-controlstudy of workers potentially exposed to styrene in thereinforced plastics and composites industry. Br IndMed 1991;47:753-62.

5 Kogevinas M, Boffetta P. Letter to the editor. Br IndMed 1991;48:575.

6 Wong 0. Reply to Kogevinas and Boffetta. Br Ind Med1991;48:575-6.

7 Marsh GM, Preininger M. OCMAP, a user oriented occu-pational cohort mortality analysis program. AmericanStatistician 1980;34:245-6.

8 Cox DR. Regression models and life tables (with discus-sion). Journal of the Royal Statistical Society 1972;34:187-220.

9 Breslow NE. Analysis of survival data under the propor-tional hazards model. International Statistical Review1975;43:45-58.

10 SAS Institute Inc. SAS/STAT Software (version 6). Cary,North Carolina: SAS Institute, 1991.

11 AD Little Inc. Industrial hygiene evaluation of retrospec-tive mortality study plants. Washington, DC: Technicalreport to the Society of the Plastics Industry, 1981.

12 Pickle LW, Mason TJ, Howard N, Hoover R, FraumeniJF. Atlas of US cancer mortality among whites: 1950-1980.Research Triangle Park: US Department of Health and

Human Services, National Institutes of Health, DHHSpub No (NIH) 87-2900, 1987.

13 Wong 0, Musselman RP. Carcinogenicity of insulationwools: further comments and some new data. RegulToxicol Pharmacol 1993;18:202-5.

14 Gubbran E, Usel M. Unusual mortality pattern among

short term workers in the perfumery industry in Geneva.BrJ7 Ind Med 1987;44:595-601.

15 McDonald AD, Fry JS, Woolley AJ, McDonald JC. Dustexposure and mortality in an American chrysotileasbestos friction products plant. Br Ind Med 1984;41:151-7.

16 Baquet CR, Horm JW, Gibbs T, Greenwald P.Socioeconomic factors and cancer incidence amongBlacks and Whites. Natl Cancer Inst 1991;83:551 -7.

17 Kaplan GA, Haan MN, Syme SL, Minkler M, WinklebyM. Socioeconomic status and health. In: Amler RW,Dull HB, eds. Closing the gap: the burden of unnecessary ill-ness. New York: Oxford University Press, 1987.

18 Petrakis NL, Ernster VL, King MC. Breast. In:Schottenfeld D, Fraumeni JF, eds. Cancer epidemiologyand prevention. Philadelphia: WB Saunders Co, 1982.

19 Okun AH, Beaumont MI, Meinhardt TJ, Crandall MS.Mortality patterns among styrene-exposed boatbuilders.Am Ind Med 1985;8:193-205.

20 Kogevinas M, Ferro G, Saracci R, et al. Cancer mortalityin an international cohort of workers exposed to styrene.In: Sorsa M, Peitonen K, Vainino H, Hemminki K, eds.Health hazards of butadiene and styrene. Lyon:International Agency for Research on Cancer sci publNo 127, 1993.

21 Kolstad HA, Lynge E, Olsen J. Cancer incidence in theDanish reinforced plastics industry. In Sorsa M,Peitonen K, Vainino H, Hemminki K, eds. HealthHazards of butadiene and styrene. Lyon: InternationalAgency for Research on Cancer sci publ No 127, 1993.

22 Coggon D, Osmond C, Pannett B, Simmonds S. WinterPD, Acheson ED. Mortality of workers exposed tostyrene in the manufacture of glass-reinforced plastics.ScandJ Work Environ Health 1987;13:94-9.

23 Day NE, Mufioz N. Esophagus. In: Schottenfeld D andFraumeni JF, eds. Cancer epidemiology and prevention.Philadelphia: WB Saunders Co, 1982.

24 Yu MC, Garabrant DH, Peters JM, Mack TM. Tobacco,alcohol, diet, occupation, and carcinoma of the esopha-gus. Cancer Res 1988;48:3843-8.

25 Magnani C, Coggon D, Osmond C, Acheson ED.Occupation and five cancers: a case-control study usingdeath certificates. BrJ7 Ind Med 1987;44:769-76.

26 Doll R and Peto J. Other asbestos-related neoplasms. In:Antman K, Aisner J, eds. Asbestos-related malignancy.Orlando: Grune and Stratton Inc, 1986.

Destruction ofmanuscriptsFrom 1 July 1985 articles submitted for the decision and the manuscripts will be keptpublication will not be returned. Authors under security for three months to deal withwhose papers are rejected will be advised of any inquiries and then destroyed.

396

Occupational allergy after exposure to caddis flies at a hydroelectric power plant

which would make them different from thepredominantly male workforce in work loca-tion 1. Although these differences could affectthe results in some types of investigations,skin prick testing is not influenced by socio-economic or sex differences. Further, analysisof the pulmonary function data was standard-ised to % predicted to control for age, height,and sex.

A further limitation in cross sectional studiessuch as this, is that the study populationinvolved an active workforce. Former employ-ees or those off sick did not participate. Forthis reason those who developed severe aller-gic symptoms after exposure to caddis fliesand left employment could not be evaluated.This selection bias tends to minimise theprevalence of problems after exposure to cad-dis flies as some of the most sensitive workersare not evaluated.

ConclusionsWorkers employed in areas thought to bemore heavily exposed to caddis flies had more

work related symptoms consistent with allergyto caddis flies and were more likely to have

evidence of skin test reactivity to caddis flyantigens. The skin response to the CCFAwas, of the three immunological tests used,the best predictor of workers having three ormore work related symptoms. Occupationalexposure to caddis flies proved to be a signifi-cant health problem at this worksite.

1 Parlato SJ. The case of coryza asthma due to sandflies(caddis flies). JAllergy 1929;1:35-42.

2 Kino T, Junichi C, Kouji F, et al. Allergy to insects inJapan. III High frequency of IgE antibody responses toinsects (moth, butterfly, caddis fly, and chironomid) inpatients with bronchial asthma and immunochemicalresponses quantitative of the insect-related airborne par-ticles smaller than 10>m in diameter. Allergy ClinImmunol 1987;79:857-66.

3 Kagen SL, Yunginger JW, Wynn SR. Occupational respi-ratory allergy due to caddis fly aeroallergens (abstract). J7Allergy Clin Immunol 1986;77:168.

4 Ferris EG. Epidemiology standardization product. Am RevRespir Dis 1979;118(suppl):1-120.

5 Peng Z, Simons FER, Becker AB. Measurements of rag-weed-specific IgE in canine serum by use of enzyme-linked immunosorbent assays, containing polyclonal andmonoclonal antibodies. Am Vet Res 1993;54:239.

6 Morris JF, Koshki A, Johnson LC. Spirometric standardsfor healthy nonsmoking adults. Am Rev Respir Dis 1971;103:57-67.

7 SAS Institute SAS procedure guide. Version 6-07. CaryNorth Carolina: SAS Institute, 1986.

8 Dean AD, Dean JA, Burton AH, et al. Epi Info, version 5:a work processing, data base, and statistics program forepidemiology and microcomputers. Stony Mountain,Georgia: USD Incorporated, 1990.

Correspondence and editorialsOccupational and Environmental Medicine wel- minimum. Letters are accepted on thecomes correspondence relating to any of the understanding that they may be subject tomaterial appearing in the journal. Results editorial revision and shortening.from preliminary or small scale studies may The journal also publishes editorials whichalso be published in the correspondence are normally specially commissioned. Thecolumn if this seems appropriate. Letters Editor welcomes suggestions regardingshould be not more than 500 words in length suitable topics; those wishing to submit anand contain a minimum of references. Tables editorial, however, should do so only afterand figures should be kept to an absolute discussion with the Editor.

413

Occupational and Environmental Medicine 1994;51:431-432

CORRESPONDENCEDust exposure and mortality inchrysotile mining, 1910-76

Scientific objectivity and the chrysotilecontroversy

The British Journal of Industrial Medicine hasbeen used to promote the interests of theAsbestos Institute, of which the longtimeDirector for Health and Environment,Jacques Dunnigan, authored a letter onchrysotile asbestos (1993;50:862-3). Thisletter includes the author's summary of apaper presented at a symposium but not yetpublished, which Dunnigan said found nooccupational risk of lung cancer in workersexposed to 45 f/ml for 20 years. (The paperwas published at the end of 1993.)'Dunnigan, whose only association listedwas University of Sherbrooke, concluded byurging "a major international re-evaluationof the case of chrysotile asbestos."

Canada's Asbestos Institute has beenjointly supported by asbestos mining com-panies and government since its formationin the mid-1980s. Its stated purpose is to"maximise the use of existing resources in aconcerted effort to defend and promote thesafe use of asbestos on a global scale." TheAsbestos Institute claims to be dedicated to"promoting the proper use of asbestos."2The President of the Asbestos Institute

told readers of The Economist that: "InSelikoff's study of American insulationworkers, asbestos victims did not onlyinhale white asbestos but were exposedmostly to amosite asbestos."3 In fact,amosite only began to be used in UnitedStates insulation in significant quantities inthe 1940s, and it does not seem that theamount of amosite ever exceeded theamount of chrysotile used in insulation inthe United States until the 1950s.4 Giventhe latency for amosite induced disease, it isclear that the mortality reported by Selikoffand coworkers since 1964 could not bemainly accounted for by the workers' his-tory of exposure to amosite. Nicholson andLandrigan have recently shown that, of the56 mesothelioma deaths in the originalSelikoff cohort through 1992, there is notthe sudden steeply rising incidence ofmesothelioma starting in the 1960s thatwould be expected if amosite (and notchrysotile) was the main cause.The Asbestos Institute's The Real Facts

on Asbestos (1990) said that: "(Third World)construction sites, however, tend not to be amajor problem as hand operated tools,which in general generate large particulatedust and not respirable dust, are widelyused." In fact, industry studies long agoshowed that hand sawing asbestos contain-ing panels generates fibre counts of 30-60f/ml.' The Asbestos Institute also success-fully opposed calls for a phase out ofasbestos in the Agenda 21 document pre-pared in connection with the Earth Summitin Brazil in 1992. Dunnigan's work for theAsbestos Institute has included the blanketcriticism of Mt Sinai asbestos experts atscientific conferences.7

Although asbestos use worldwidedeclined one third from previous levels in1990-3, the power of asbestos interests pastand present can hardly be ignored. Propertyowners and insurers would still prefer toavoid spending billions to comply with strictrules for asbestos abatement: former manu-

facturers would benefit financially from anofficial report that said that chrysotile doesnot cause mesothelioma among workerswho used their chrysotile products; andasbestos mining and manufacturing inter-ests would very much like to prevent theirremaining market countries from adoptingpolicies to phase out the use of chrysotile.The international re-evaluation of the

case against chrysotile that Dunnigan calledfor is now under way. The InternationalProgramme on Chemical Safety (IPCS), anagency of the World Health Organisation,has selected a group to prepare a report onchrysotile that is so loaded in favour ofasbestos interests that it has beendenounced by the National Institute forOccupational Safety and Health, CollegiumRamazzini, and Dr Philip Landrigan at theMt Sinai School of Medicine in New York.The National Institute for OccupationalSafety and Health took the occasion to citecorporate influence on IPCS reports onother substances in the past and announceits withdrawal from participation in IPCSactivities.8 The Collegium refused to beinvolved in the review process of the IPCSreport on chrysotile, and urged that IPCSdefer development of this report "preparedby scientists with close ties to the asbestosindustry." I

It is remarkable that debate over the car-cinogenicity of chrysotile could be pro-longed anymore. But it is a hopeful signthat independent scientists and participat-ing United States institutions are takingunprecedented steps to deal with concernsabout the scientific objectivity of the IPCScriteria document on asbestos.'0

BARRY I CASTLEMAN1722 Linden Avenue,

Baltimore MD 21217, USA

1 McDonald JC, Liddell FDK, Dufresne A,McDonald AD. The 1891-1920 birthcohort of Quebec chrysotile miners andmillers: mortality 1976-88. Br J Ind Med1993;50: 1073-81.

2 Asbestos Institute. Asbestos. Vol. 1 (No 1).Quebec: Asbestos Institute, 1985.

3 Forget C. Dusty reply. The Economist p 8(December 12 1987).

4 Selikoff JJ, Hammond EC, Churg J. Mortalityexperiences of asbestos insulation workers.Pneumoconiosis/Proceedings of the InternationalConference, Johannesburg 1969 (II Shapiro,ed), Cape Town: Oxford University Press,1970:180-6.

5 Nicholson WJ, Landrigan JF. The carcino-genicity of chrysotile asbestos. Adv ModEnviron Toxicol 1994;22 (in press).

6 Cross AA. Practical methods for the protection ofmen working with asbestos materials in shi-yards. Safety and health in shipbuilding andship repairing. Geneva: International LabourOffice, 1972:93-101.

7 Mitastein M, ed. Proceedings Meeting onAsbestos and Health in Latin America. PanAmerican Health Organization, MexicoCity, 1987:74-5.

8 Lemen RA. National Institute forOccupational Safety and Health (US).Letter to M Mercier, IPCS, undated(1993). See also Watterson. Chemical haz-ards and public confidence. Lancet 1993;342:131-2.

9 Maltoni C. Collegium Ramazzine. Letter toM Mercier (IPCS) 2 November 1993.

10 Lee PR, Assistant Secretary of Health, USDepartment of Health and Human Services.Letter to J Fite (White Lung Association),3 March 1994.

Editor,-The final issue of the BJIMincluded a thoughtful essay by David Muirentitled Bias (1993;50:1122-1123). It alsoconcluded the Editor's Choice series withthe 1980 paper by Corbett McDonald et alon the Canadian chrysotile miners' experi-ence (1993;50:1058-1072). The introduc-tion made the unqualified observation that,"He and his colleagues were subjected to acampaign of vituperation that was designedto achieve political rather than scientificends." There is the danger that the generalreader will believe that there was only onevictim in the polemic games that wereplayed in the asbestos field. A statement outof context such as this is an example of aform of bias that Muir might like to add tohis collection. Mud was slung generouslyfrom both "sides" in the battles of asbestos,which were not invariably fought accordingto Marquis of Queensberry rules. As a con-sequence scientists deemed to be on oppos-ing sides, were both demonised or beatifiedas it served the polemicists. In 1974 it wasapparent that for a more confident under-standing of the dose responses of asbestosexposure, the data collected by CorbettMcDonald and by Irving Selikoff requiredto be reviewed. I discussed this in 1974 withMargaret Becklake, who was McDonald'scolleague at McGill, and we agreed on thedesirability of such a rapprochement. Solong as the experts were seen to be atloggerheads and trivialised, there could beinertia in developing better worker protec-tion. Some correspondence survives be-tween the two principals and with JohnGilson, who offered his services to help setup the scientific review and overcome thedivision. At one stage a meeting was to takeplace between McDonald and Selikoff at aneutral site in Albany to initiate collabora-tion. Alas! It never came off. Publication ofthe McDonald/Selikoff/Gilson correspon-dence would be of considerable interest butalone would be insufficient for an under-standing of a complex situation. It wouldrequire to be read in the context of a studyof the battles that successfully preserved theasbestos industry. Various exposes havebeen published, but a historian's accountremains to be written of the conduct ofthese battles as does the extent to which thescientists' differences were exploited.The introduction also stated that

"McDonald's work over the years . . laidlow the fallacy of the notion that a singlefibre could cause cancer." Hardly a claimthat an epidemiologist would make, but itsappearance in a prestigious journal will giveit a life of its own and it will be cited hence-forth as a fact.

MORRIS GREENBERG74 North End Road,London NWI1 7SY

NOTICES

The 14th Asian Conference onOccupational Health; 15-17 October1994, Beijing, China

The main theme of the 14th AsianConference on Occupational Health is

431

Book review

Health protection and health promo-tion in the workplace. To offer an oppor-tunity of presenting achievements in thisfield and also provide a forum for a broadexchange of views and experience in occu-pational health and safety, the scientificprogramme includes the following topics:occupational epidemiology; environmentaland biological monitoring; medical surveil-lance; industrial toxicology; ergonomics;mental health; neurobehavioural methods;computers in occupational health; pneumo-

,coniosis; occupational lung diseases; occu-pational cancers; industrial poisoning;pesticide poisoning; occupational skin dis-eases; physical hazards; musculoskeletal dis-eases; work-related diseases; agriculture;mining industries; chemical hazards andcontrol; small scale industries; occupationalhealth service; prevention of occupationalinjuries; prevention of occupational dis-eases; health promotion; education andtraining; occupational safety; womenworkers; other topics of occuational medi-cine and related sciences.The official language of the conference is

English.For further information, please contact:

Conference Secretariat, The 14th AsianConference on Occupational Health, c/oInstitute of Occupational Medicine,Chinese Academy of Preventive Medicine,29 Nan Wei Road, Beijing 100050, PRChina. Tel (86 l)-301-4323 or (86 1) 301-5751. Fax (86 1)-301-4323. Cable 8761.

E-mail ZOUCQ%BEPC2@SLACVX.BITNET.

Workshop: health protection ofworkersexposed to pesticides. 16 October 1994,Beijing, China

The organizing committee of the 14th AsianConference on Occupational Health ispleased to announce the Workshop "Healthprotection of workers exposed to pesti-cides", which is jointly organised with theScientific Committee on Pesticides of theInternational Commission on OccupationalHealth and the International Centre forPesticide Safety, a World HealthOrganisation Collaborating Institute estab-lished in Milano, Italy.The workshop is part of the programme

of the 14th Asian Conference onOccupational Health and is directed atoccupational health professionals who dealwith workers exposed to pesticides.The provisional programme of the work-

shop includes:* A plenary lecture on health surveillance

of workers exposed to pesticides.* A session on recent advances in toxi-

cology of pesticides with keynoteaddresses and oral presentations andposters contributed by the participants.

* A session on management of health riskfrom pesticides in workers with keynote

addresses on the following themes:assessment of exposure; biological moni-toring; personal protection measures andhygiene; training and education of users.Oral presentations and posters will becontributed by the participants.For further information on the workshop,

please contact: Conference Secretariat,Professor Changqi Zou, Institute ofOccupational Medicine, Chinese Academyof Preventive Medicine, 29 Nan Wei Road,Beijing 100050, PR China. Tel (+86 1)301-4323 (86 1) 301-5751. Fax (+86 1)301-4323. Cable 8761; or Professor MarcoMaroni, Director ICPS-InternationalCentre for Pesticide Safety, Via Magenta25, 20020 Busto Garolfo (Milano), Italy.Tel (+39 331) 568091. Fax (+39 331)568023.

NRPB training courses in laser safety

Training in laser safety has become increas-ingly important as more and more peoplecome into contact with lasers in the courseof their work.The National Radiological Protection

Board and Loughborough University ofTechnology have combined their respectiveexperience in radiological protection andlaser safety research and arranged six train-ing courses on laser safety during 1994. Thecourses will be held at the Burleigh CourtConference Centre at LoughboroughUniversity.The range of courses on offer reflects the

varying training requirements of peoplewhose work brings them into contact withlasers. The five-day course for laser safetyofficers is aimed at those responsible forlaser safety in industry and in research,including laser manufacturers and suppliers.This course balances the theoretical aspectsof laser safety with practical measurementand risk assessment exercises. The two-daycourse for users of lasers covers a widerange of applications including thoseinvolved with servicing, testing and mainte-nance of lasers; it includes hazard assess-ment and limitation. The one-day course isdesigned for those whose work may bringthem into occasional contact with lasers orwho need an overview of laser safety, suchas company safety officers, general man-agers and trades union safety representa-tives. This course assumes no previousknowledge of laser technology, and providesa basic understanding of lasers, their opera-tion and applications, together with theassociated safety issues.

Further information on these courses isavailable from: John O'Hagan, NationalRadiological Protection Board, Chilton,Didcot, Oxon OX 1I ORQ. Telephone 0235831600 Ext 2451; Fax 0235 833891; Telex837124 RADPRO G, or Jackie Baseley(Loughborough University of Technology)Telephone 0509 223232.

BOOK REVIEW

Principles and Practice of Environ-mental Medicine. Edited by A B Tarcher.(Pp 632; price US$85). 1994. New Yorkand London: Plenum Medical BookCompany. ISBN 0-306-42893-8.

Although the effects of the environment onhealth have long been recognised, interesthas been growing rapidly during the past 10or so years. Concern about "the environ-ment" has acquired overtones of politicalcorrectness and, although assertions thatpollution of the environment is severelydamaging health are often poorly founded,the desire to return to an unpolluted worldis felt by many. This book is therefore awelcome addition to reasoned discussion ofone of the pressing problems of today.Dr Tarcher's book is aimed at the trainee

in environmental medicine-there shouldbe more such people-and would make agood choice as the set book for a masterscourse in environmental medicine orenvironmental toxicology. It will also be ofvalue to the established worker who needs asource of reference in areas with which he isnot in daily contact. Much information isprovided on basic concepts and the tutorialnature of the book inevitably leads to somerepetition. This can be annoying: the lungis dealt with in three separate, non-consecutive, chapters. The sum of the sec-tions dealing with the lung is, however,admirable: as would be expected when con-tributions by authors of the standing of J DSpengler are included.The chapters that the editor has con-

tributed to or written are among the best inthe book. Sadly, I suspect that older work-ers will not read them: they will miss a lot.The clear descriptions of methods of epi-demiological study, the need for appropriatemonitoring of pollutants, and the considera-tion of causes of enhanced susceptibility tothe effects of environmental hazards are allinformative. The lengthy appendices, par-ticularly that providing information onwhere to look for further advice, are a valu-able innovation.What then is wrong with this book? Not

much as far as I can see. The coverage isgood, the separation of principle and prac-tice is clear, the referencing is as up to dateas one can reasonably expect from such alarge work, and the proof reading has beenunusually precise.In conclusion, if you are looking for an up

to date account of environmental medicinefor use by your students and yourself at areasonable price, buy this book.

R L MAYNARD

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