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Book Review: Exposure Assessment in Occupational and

Environmental Epidemiology. Mark J. Nieuwenhuijsen (Editor). Oxford
University Press, Oxford. ISBN 0-19-852861-2.

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Book Reviews
Exposure Assessment in Occupational and Envir-
onmental Epidemiology. Mark J. Nieuwenhuijsen
(Editor). Oxford University Press, Oxford. ISBN
0-19-852861-2. Price £36.50.
An accurate measure of exposure is crucial for
epidemiological research which attempts to relate
exposure to external agents with the occurrence of
particular diseases. The aim of this book is to increase
our knowledge and understanding of exposure assess-
ment methods and how they can be applied in occu-
pational and environmental epidemiology.
In the light of the recent and rapid expansion of
the field of occupational and environmental epide-
miology and health risk assessment, this book pro-
vides a timely focus on both exposure assessment
methods. This is probably the first textbook that
explicitly tries to bridge the gap between the fields
of occupational and environmental exposure assess-
ment. This book assembles expert knowledge from
diverse disciplines, including engineering, statistics,
toxicology and environmental science, in an
attempt to generate some coherence in the applica-
tion of these methods to epidemiological research.
In addition, it provides a number of cases studies of
current topical research in the exposure assessment
of allergens, particulate matter, chlorination disin-
fection by-products, agricultural pesticides and radio
frequencies.
The overall impression is a positive one as the book
incorporates contributions from recognized experts in
occupational and environmental epidemiological stu-
dies. The book covers the methodology of exposure
assessment including questionnaires, environmental
design and modelling, personal/dermal exposure
and exposure surrogates, biological monitoring and
design issues of exposure measurement, including
measurement error and the consequences. The second
half of the book covers the current status of the appli-
cation of these methods and current research
questions.
The structure of the book is logical and coherent
and a useful reference for those with a specialist
interest in this field. Perhaps those looking for
a more general textbook might be referred to the
579
Ann. occup. Hyg., Vol. 48, No. 6, pp. 579–581, 2004
# 2004 British Occupational Hygiene Society
Published by Oxford University Press
Principles and Exposure Measurement in Epidemiol-
ogy by Armstrong, White and Sarracci. Armstrong’s
text provides a solid grounding for those involved in
the design or conduct of epidemiological studies and
has served well as a text for those undertaking grad-
uate courses in epidemiology. It remains a broader
publication and more strongly represents a textbook
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of principles. There are some evident overlaps
between the two texts (e.g. chapters on questionnaires
and exposure measurement error). Nieuwenhuijsen’s
text nevertheless provides an update from the decade
that has passed since the publication of Armstrong’s
text.
In Nieuwenhuijsen’s text, Chapter 7 by Wolfgang
Ahrens and Patricia Stewart is particularly useful in
addressing issues surrounding the accuracy, reliabil-
ity and validity of information in any given study and
the issues surrounding the accuracy of retrospective
exposure assessment, with reference to the recon-
struction of past exposure.
Chapter 16 by Mustafa Dosemeci, an author well
recognized in his field, also provides a useful over-
view of subject- and pesticide-specific exposure with
regard to occupational epidemiology. Dosemeci
reviews the procedures used to evaluate pesticide
exposures in epidemiological studies of cancer,
with a focus on the agricultural setting. In this chapter
the author makes suggestions for future exposure
assessment procedures, for example those which
may allow the evaluation of relationships between
an unlimited number of genetic susceptibility markers
and the exposure under question, without losing the
power of the study.
The book also addresses newer challenges not
previously covered in textbooks of exposure
measurement. For example, Chapter 17 by Martie
van Tongeren and Philip Chadwick examines the
relationship between radio frequency and electro-
magnetic radiation and cancer, a topic of increasing
importance in the light of recent developments in
telecommunications.
Nieuwenhuijsen’s book touches upon Bayesian
analysis, a statistical technique for population mod-
elling. These methods are becoming increasingly
popular and so it would be useful for future texts
to review these methods in further detail. Addition-
ally, future texts or a second volume might expand
 580 Book reviews
further on genetic markers of exposure and other
biomarkers.
This book would certainly be of particular rele-
vance to those with a specialist interest in exposure
assessment in occupational and environmental epide-
miology, rather than appealing to a wider audience
of those working in the general field of
epidemiology. It would also be of interest to those
occupational hygienists with an interest in environ-
mental issues.
KENNETH MUIR and HOLLY BLAKE
Division of Epidemiology and Public Health,
School of Community Health Sciences,
University of Nottingham Medical School,
Nottingham, UK
doi:10.1093/annhyg/meh053
Published online 6 August 2004
Environmental Health Science: Recognition,
Evaluation and Control of Chemicals and Physical
Health Hazards. Morton Lippmann, Beverley S.
Cohen and Richard B. Schlesinger. Oxford University
Press, Oxford, 2003. ISBN 0-19-508374-1. Price £40.00.
558 pp.
This is an excellent book that comprehensively covers
the health impact of man’s interaction with his envir-
onment. It is an update of Chemical Contamination in
the Human Environment, published in 1979, and,
although aimed at a broad church of scientific dis-
ciplines, crossing the fields of physics, ecology,
chemistry and biology, the second part of the title
of this book should attract the attention of anyone
involved in occupational hygiene. Indeed, the expres-
sion ‘recognition, evaluation and control’ is often the
definition I provide at dinner parties when asked what
a hygienist does.
In 15 clear and well-constructed chapters, this
book progresses the reader through an understanding
of sources of contaminants; how contaminants dis-
perse, mix and interact within the atmosphere, aquatic
environment, land and soil; how chemicals and phy-
sical agents can cause health effects in humans; tech-
niques for measurement of human exposure; and how
we can use exposure data for risk assessment and risk
management purposes. The three chapters on envir-
onmental noise, non-ionizing radiation and ionizing
radiation are particularly well explained for the
non-expert.
The ambitious aim of the authors to provide a com-
prehensive overview of health risks posed by chemi-
cals and physical agents in the total environment is, in
the main, achieved. They cover an extensive range of
topics, writing in an easy to understand format while
taking the reader to some depth on subject areas as
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diverse as the effects of air pollution on health, risk
communication and the use of cost–benefit analysis in
evaluating environmental legislation.
The style is scientific writing at its best. It is clear,
crisp and peppered with interesting examples and sup-
porting material to keep the reader connected with the
subject matter. There is a generous use of excellent
figures, tables and graphs to back up the text.
On the downside, the book is written from an
American perspective and, particularly in relation
to the historical development of legislation and cur-
rent standards, it centres almost entirely on the experi-
ence of the USA. It is perhaps impossible to be
globally inclusive in these matters, but as a European
reader, I wanted a little more than the single para-
graph provided on ‘occupational health standards
in other nations’, which seemed to imply that most
European Union countries have adopted the MAK
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values developed by Germany.
Many of those involved in the science of occupa-
tional hygiene have come from different
backgrounds: some are engineers, some are toxi-
cologists, and others are from more medically orien-
tated subject areas. Indeed one of the strengths of
occupational hygiene is that it has learned from
and can call upon expertise across such a span of
scientific experience. There is a perception, however,
that the occupational and environmental arenas are
distinct, with occupational exposures being of a dif-
ferent magnitude to environmental contamination.
This book repeatedly shatters that divide. It shows
time and time again that the principles and methods
used to sample, model and understand environmental
contamination are similar to those used by occupa-
tional hygienists. Our understanding of dermal,
respiratory and ingestion exposure assessment meth-
ods is similar in both fields. If we consider workers’
health in a holistic manner, as we should aim to do in
occupational hygiene, then there is a need to under-
stand the environmental factors that can influence
health and well being. This book provides a bridge
to help us identify the many areas of overlap there are
between occupational and environmental exposures
that impact on human health. Although broad in its
scope, this book achieves an excellent balance of
simple explanation and detail. I can thoroughly
recommend Environmental Health Science for all
those practicing hygiene and with an interest in
hygiene and human exposure science.
SEAN SEMPLE
Department of Environmental & Occupational
Medicine, University of Aberdeen,
Aberdeen AB25 2ZP, UK
doi:10.1093/annhyg/meh057
Published online 6 August 2004