Ann. occup. Hyg., Vol. 47, No. 2, pp. 173-174, 2003
© 2003 British Occupational Hygiene Society
Published by Oxford University Press
Book Review |
WHO EHC 223: Neurotoxicity Risk Assessment for Human Health: Principles and Approaches
School of Health and Policy Studies, University of Central England, Birmingham B42 2SU, UK
WHO EHC 223: Neurotoxicity Risk Assessment for Human Health: Principles and Approaches. ISBN 92-4-157223-X. Price Sw.fr. 48 (£20). 223 pp.
This book, in following the objectives of the Environmental Health Criteria (EHC) monographs, has some lofty goals to achieve: addressing the knowledge gaps concerning health effects of pollutants; promoting harmonious links between epidemiology and toxicology; and providing evidence for exposure limit setting. With that in mind, the overall aim of this book could be nothing other than important—a logical attempt at assessing the information obtained thus far on the relationship between exposure to environmental pollutants and human health. The impressive panel comprising the task group behind the book, and the 64 reviewers of the work suggest how seriously the above scope is taken.
The size of this book betrays the depth and breadth of the coverage within, which is equivalent to many degree-quality textbooks. Whether using this series of monographs as a reader new to the field, or as someone revisiting core principles, the contents are informative and clear, with a clutter-free style. The preamble emphasizes the care and consideration taken by the authors in selecting evidence sources for the basis of this book, with the scope, content and procedures for inclusion of work in EHC monographs being reassuringly stated.
The Introduction covers many subtle areas that readers may feel they need to revisit occasionally—clarifying such distinctions as neurotoxicity versus adverse effects, and direct versus indirect effects. There is a generous section covering the basic principles of neurotoxicity risk assessment, including neurobiological principles of structure, transportation, channels, neurotransmission, metabolism and many more. By weaving interestingly from a cellular level to a behavioural one, and then back again, examples are presented in an effective way.
One suspects that because this book takes a back-to-basics approach to the area, it is targeted at individuals who may have previously shied away from serious toxicology or rudimentary research principles. While that can be a criticism of many books, it is certainly not the case here, and the fundamental principles of physiology, biochemistry and neurotoxicology that are covered segue neatly into the more advanced and specialist concepts. This makes the book both interesting and accessible to many additional professions—occupational hygienists and other occupational health practitioners, research scientists and regulators.
The 13 recommendations concerning improvements in future research methodology that are made at the beginning of the book (the stall is clearly laid out here) are to be expected and are not surprising. Their collective aim is to ‘employ effective control and intervention strategies to prevent human neurotoxicity’ through the development of a more robust knowledge base. The pleasure, however, is in the way the recommendations begin to make intuitive sense as one proceeds through the text. Starting this journey by presenting the destination first actually makes for a more sensible and easier journey than it perhaps sounds.
On the practical side, the section on human neurotoxicity studies gives many examples of individual neurobehavioural and neuropsychological tests and test batteries, along with summaries of potential methodological flaws and limitations present in such testing. Examples of different research approaches and study designs are also broadly evaluated for their role in providing valid evidence in this field. Such understanding makes this book useful for those wishing to conduct active research in the area, or those who need to be able to critically evaluate research. Human experimental studies are also covered, as well as the ethics and methodology appropriate to such investigations.
Because of the broad description of neurotoxicological research contained within this book, it doubles as a guide on general research methodology, principles and practices, with more interesting specialist data and depth there for those who want it. In addition, because of the general lack of adequate human exposure and toxicity data for the majority of chemicals, the important role of animal studies in the development of hazard identification for risk assessment is not ignored. The balance of pages dedicated to human research (43) and animal studies (57) is appropriate considering this, and the volume of animal studies contained in a book on human health is thereby justified. The multitude of possible outcomes from animal models relative to human studies is responsibly compared here with human studies where possible.
The final chapter adequately describes the evolution of quantitative neurotoxicity risk assessment, and reasonably covers the steps of hazard identification, dose–response assessments, exposure assessments and the characterization of risk. Although I personally found this chapter to be the least interesting within the book (perhaps due to one approaching this book as an active researcher rather than a risk manager or policy-maker), the preceding chapters had already convinced me that this is an interesting and worthwhile summary of the best evidence available in the field. What is more, in providing useful methodological advice and a good summary of animal neurotoxicity studies, this book has provided much more information than it promised to deliver on the cover. Recommended.
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