Environmental Health: From Global to Local

Article excerpt

Environmental Health: From Global to Local

Edited by Howard Frumkin

San Francisco:Jossey-Bass, 2005. 1,108 pp.

ISBN: 0-7879-7383-1, $75.00

Howard Frumkin has been a leader in expanding the definition of environmental health beyond the effects of toxic chemicals. His eloquence and breadth of understanding are evident in the introductory chapter to this textbook, as well as in his chapter "Nature Contact: a Health Benefit?" The book's 36 chapters contain highly pertinent insights and information on environmental issues that go beyond the usual boundaries of classic environmental health. Among the many excellent chapters are ones on climate change, ecology, urbanization, environmental justice, developing nations, health care services, energy production, genetics, indoor air pollution, religious issues, clinical services, legal remedies, environmental health policy, and transportation. This breadth makes the book a very useful reference source. Unfortunately, so much of the basics of classic environmental health are omitted or insufficiently presented that the book is not suitable as a textbook for standard undergraduate or graduate environmental health courses.

Core concepts in classic toxicology and in risk assessment related to environmental chemicals receive minimal attention. For example, there is little or nothing on such topics as threshold and nonthreshold dose responses; traditional chemical safety factors; reference doses; weight of evidence for carcinogenicity; and other standard approaches to evaluating personal and community risk from chemicals. The linkage between environmental exposure and dose, including internal dose and dose to target tissue, is only scantily presented. Classic environmental health concepts such as bioavailability, bioaccumulation, and biomagnification are not systematically addressed. The risk assessment chapter focuses almost totally on cancer risk, but without mentioning the International Agency for Research on Cancer or the National Toxicology Program processes for hazard identification of carcinogens. Cumulative risk is briefly touched on in the excellent chapter on environmental justice--but with no mention of aggregate risk. Environmental indicators are discussed only in relation to water pollution, and the exciting new advances in this area are not integrated or referenced; biomonitoring is only briefly mentioned in the discussion of industrial hygiene; and biomarkers only in relation to exposure, but not to effect or susceptibility. These basic concepts, as well as information about the health effects and mechanisms of toxicity of major environmental chemicals, are central to teaching the environmental health sciences to undergraduate and graduate students.

Emblematic of the disconnect between the excellence of a chapter and value as a textbook is the treatment of exposure assessment and of informatics. The superb chapter on industrial hygiene only peripherally addresses environmental exposure assessment, a crucial component of classic environmental health. Omitted are conceptual and technical advances that have contributed heavily to advances in environmental protection. This chapter does contain a brief discussion of dose issues missing from the toxicology chapter, although its example of carbon monoxide is unfortunate in omitting time to equilibrium and CO production through normal metabolism. Similarly, informatics has developed two major areas in environmental health: geographic information systems (GIS) and computational chemical toxicology. …