Reviews

Generations at Risk: Reproductive Health and the Environment

Ted Schettler, Gina Solomon, Maria Valenti, Annette Huddle

MIT Press, £20.95, pp 430 

ISBN 0 262 19413 9

Rating:

Children are among the most sensitive populations to environmental health hazards. Their routine exposure to toxic chemicals in homes and communities can put them at risk of health problems. Central to the ability to protect our communities and families is exercising our right to know about toxic hazards. For many, the only source of environmental information is media reports, which often leave the public feeling confused and powerless. Making sense of pages of information and data presented in different formats and measurement units is a challenge to BMJ reviewers let alone people with non-technical backgrounds. To benefit from public access to information, the community needs details of how to obtain useful environmental and health information, resources for interpreting these sources, an understanding of basic principles for evaluating health risks, knowledge of how to obtain help in understanding technical or specialised information, and familiarity with strategies for pollution prevention or risk reduction.

Between 1969 and 1979, 12 children were diagnosed with leukaemia in Woburn, Massachusetts. The first to notice that too many childhood leukaemias were being identified in her neighbourhood was one of the children's mothers. Shortly after the cluster was identified, environmental agencies found that chemicals from a nearby industrial property had contaminated drinking water in the area. These citizens' efforts to prompt research and to address this tragic health problem have provided important lessons on community environmental health advocacy, as well as inspiring the film Civil Action. Would accessible information have helped their search?

Generations at Risk describes itself as a source book on human exposure to toxic chemicals that can have reproduction and development effects. Its suggested readership is those concerned about their family's health and medical and public health workers. It attempts to provide scientific information with which to assess the health risk of many chemicals, as well as a guide to regulatory systems and resources for action. It presents summaries on reproductive and developmental physiology and the role of science in public health decisions, and is a useful primer for clinicians. Treatises on substances and exposures are less accessible, however, especially to the non-technical citizen, and the emphasis on US regulations and sources diminishes its broader appeal.

Would it have helped the citizens of Woburn by giving them scientific information in a readable form? Unfortunately, it only rises partially to the challenge. It's well worth a dip for the specialist, but not for its declared broader audience.

Donald Campbell, public health medicine specialist. 

Public Health Protection, Auckland Healthcare, New Zealand