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Air pollution and health.

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    Air pollution and health. Edited by: stephen t holgate, jonathan m samet, hillel s koren, robert l maynard. (Pp 1065; £79.95) 1999. San Diego and London: Academic Press. ISBN 0-12-353225-4.

    Among the most serious dangers to public health is air pollution. It is at least as important as cancer and vascular disease as a cause of death, illness, and lost human potential, it is a major source of environmental damage, and it seems to be an inescapable accompaniment of industrial progress. In the 19th century we measured a country's power by its production of sulphuric acid, perhaps we should now do so by the acid particles breathed by its citizens? After the very obvious air borne disasters of the 1950s due to fogs in Britain, Mexico, and the USA, there was a rapid legislative and technical response to reduce obvious sources of pollution, and then medical and scientific attention fell away until the growing menace of asthma and other respiratory diseases, coupled with our better ability to detect and measure airborne substances showed that the problems were as serious as ever, even if more subtle in their form and attack.

    This book rightly claims to be the first attempt to produce a comprehensive account of the sources, mechanisms, physical behaviour, and health effects of air pollution, and of approaches to its regulation, including forays into economics, trade offs between risk and benefit, and communication about risk with the public. There are 68 authors from Europe and the Americas, all of whom are making active contributions to understanding this huge area. Considering their research interests, they have been surprisingly well marshalled by the four distinguished editors into writing up to date, readable, and informative chapters.

    The general approach has been encyclopaedic as the nine major sections cover the history of air pollution, physical meteorology, atmospheric chemistry, the physical geography of air pollution related to its main sources, the measurement of personal exposure, health effects in humans and in laboratory systems, details of major chemical and particulate pollutants, the estimation of health and financial impacts and approaches to regulation including national and international setting of standards for air, and two way communication with the public. The text is accompanied by many clear diagrams and graphs, and several helpful photomicrographs, and every chapter carries many pertinent and recent (to 1998) references.

    The strengths of this book are its breadth and clarity, and so its value both as a source of analysed information and conclusions, and as an entry point into the detailed research literature. I particularly appreciated the information abut meteorology, atmospheric chemistry, and surveillance and measuring strategies for the biologist, and the focused accounts of epidemiology and respiratory physiology, defences, and diseases, which should inform the physical scientist about the subtle difficulties of biology. Its weaknesses are those of any synoptic work—the reader must have some background knowledge to understand the depths of the knowledge presented, and the need for broad coverage prevents the inclusion of extensive detail. The balance seemed correct to me in most respects, as the references always pointed to original sources that could be read with appropriate cautions and criticisms in mind.

    Physicians at any level, public health officials, and sanitary engineers should consult this book regularly. It will be of as much value and interest to regulators, lawyers, and industrial engineers looking into the causes and possible controls over air pollution and it will be a major source for any public group wishing to know more of the facts and do something about the aerial refuse we now breathe.

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