Book reviews

seem to lean more on popularly accepted
views than on hard proof Recent work has
shown that air pollutants can increase the
response of the airways to allergens; the key
question is to what extent does this occur at
ambient levels of pollution. This is harder to
answer but if not mentioned the reader is
left with the impression that the effect is of
known importance.
The chapters dealing with solutions are

helpful. Much useful information has been
collected and tabulated. This will be an
important source for students, especially as
the "grey literature" in this area can be diffi-
cult to trace.

Costs and benefits are considered but not
in great depth. For comparatively wealthy
countries, air pollution is a soluble problem,
for poor countries this may not be the case
for some years yet. Given that industrial
countries are inevitably in competition with
one another it is not easy to see that rich
countries will wish to help the less fortunate
to enjoy a clean industrial revolution. Sadly,
the old administrative adage "costs lie where
they fall" seems to apply on a global scale.

In conclusion, this is a useful and inex-
pensive book which deals with an important
problem. The more advanced reader will
wish to follow up some of the author's
points in the original literature-if he does
so then he will find the picture is less clear
cut than presented in Smog Alert.

R L MAYNARD

Environmental Hazards and Human
Health by RICHARD B PHILP. (Pp 306; price
,C55.) 1995. Boca Raton, FL: CRC Press.
ISBN 1-56670-133-3.

As the author of this title proclaims, it is
increasingly necessary for students of
environmental sciences to know something
of toxicology, and for students of toxicology
to know something of the environment; the
intention of Environmental Hazards and
Human Health is to bridge that gap. The
chapter titles range from water pollution
through radiation hazards to risk analysis
and the Gaia concept.

This book is both lively and readable. Its
intended aims are ambitious and its content
comprehensive, but it somehow falls short of
fully meeting its objectives. This may be due
to the rather idiosyncratic style and the
patchyness of the text. Although it
frequently makes interesting reading, the
material presented is often sketchy and
selective. It also lacks formal referencing.
Thus the material sometimes has an
anecdotal feel, although balancing this is the
author's personal touch and the inclusion of
some unusual and useful snippets of
material.

It seems to be a prerequisite nowadays to
preface any text or chapter on toxicology or
pharmacology with a quote from Paracelsus.

This one is no exception, although the quote
used is more accurate than usual. It seems
ironic that Paracelsus is so often used in this
context as the point he was making referred
in fact to the homeopathic usage of known
poisons. As a general comment, I was not
sure that the introductory quotes in this
book contributed significantly.
Not surprisingly, perhaps, in a book of

this kind covering a very broad range of top-
ics, some sections are lengthy and detailed
whereas others seem short and superficial.
Moreover, the material sometimes seems
rather too simplistic and does not always
adequately support the review questions
given at the end of each chapter. Indeed, I
was not convinced about the appropriate-
ness of these questions or of the case studies
provided. Also, it has to be said that the
illustrations are not of the highest quality;
they are all in black and white and often
rather crude in comparison with the superb
graphics increasingly commonplace in books
of this ilk. In terms of completeness and top-
icality of its contents, I was surprised not to
see PM,0 mentioned by name. Nor was there
a reference as such to environmental oestro-
gens and the increasing evidence regarding
the endocrine disrupting properties of chem-
icals, which is currently a very topical issue
in terms of both scientific and public inter-
est.
My overriding impression of this book

was of a brave, if not wholly successful,
attempt to cover all the key issues in this
vast subject area. Although perhaps trying to
achieve too much, the author nevertheless
has produced a reader friendly overview for
students needing basic information on a
wide range of topics in the environment and
health field, and I am sure the book will
receive a wide readership. At £55 this hard-
back book is reasonable value for money.

PAUL HARRISON

Traumatic Stress in Critical
Occupations, Recognition, Con-
sequences, and Treatment. By DOUGLAS
PATON, JOHN M VIOLANT. (Pp 245.) 1996.
Springfield, Il: Charles C Thomas. ISBN 0-
398-065772.

The poet Ralph Waldo Emerson described
the simple reality of the experiences of
human beings in traumatic situations when
he mused "we boil at different degrees".
This book attempts to explore not only each
person's reaction to traumatic stressful situa-
tions, but also the "complex interactions
between the person, the traumatic event,
and the social and organizational back-
ground against which performance takes
place". The emphasis here is on understand-
ing the stress and trauma phenomena and
developing an "effective trauma manage-
ment system". This duality of objectives,
highlighting the current theory in the field

and the practical solutions is laudable. Also,
by encompassing the phrase "critical occu-
pations", the authors have widened the con-
ventional view of traumatic stress being
associated with the emergency services only,
extending the construct to the "helping pro-
fessionals" as well.
The book is divided into eight chapters,

the first two of which are concerned with a
broad overview of the field and by research
considerations on methodology and assess-
ment strategies. The next four chapters
explore specific critical occupations such as
emergency medical service workers, the
police, and disaster relief agencies. Most of
these cover not only the research undertaken
but also education, prevention, and support
approaches. The last two chapters, from my
point of view, are the most interesting, as
they explore the training and support for
emergency responders and future issues in
the area of practice and research. The issues
of training and preparation, support and
demands related to the event, and recovery
and the social and organizational influences
are assessed in depth. The assessment of
occupational trauma is examined in the final
chapter, with an emphasis on the need to
carry out research which is longitudinal in
nature and to explore a range of preventive
strategies rarely discussed-for example,
screening.

This volume really does make a contribu-
tion, both in terms of future research and
strategies that organisations might adopt in
coping with traumatic stress at work. It is up
to date and clarifies many of the method-
ological and occupational issues currently
confronting the field of traumatic stress in
an organizational context. It is not a cure all
or a simple "do it yourself' guide to corpo-
rate post-traumatic stress disorder, but a
step in the right direction of an increasing
problem among critical occupational groups.
What is important for the health of employ-
ees in any work environment, as this book
reinforces time and time again, is to provide
a creative and supportive organizational cul-
ture. This can be done if we follow the sim-
ple dictat of Kornhauser, over 30 years ago,
in his book The mental health of the industrial
worker. "Mental health is not so much a
freedom from specific frustrations as it is an
overall balanced relationship to the world,
which permits a person to maintain a realis-
tic, positive belief in himself and his pur-
poseful activities. Insofar as his entire job
and life situation facilitate and support such
feelings of adequacy, inner security, and
meaningfulness of his existence, it can be
presumed that his mental health will tend to
be good. What is important in a negative
way is not any single characteristic of his sit-
uation but everything that deprives the per-
son of purpose and zest, that leaves him with
negative feelings about himself, with anxi-
eties, tensions, a sense of lostness, empti-
ness, and futility."

CARY L COOPER

144

 o
n
 A

p
ril 5

, 2
0

2
1

 b
y g

u
e
st. P

ro
te

cte
d
 b

y co
p
yrig

h
t.

h
ttp

://o
e

m
.b

m
j.co

m
/

O
ccu

p
 E

n
viro

n
 M

e
d

: first p
u

b
lish

e
d

 a
s 1

0
.1

1
3

6
/o

e
m

.5
4

.2
.1

4
4

-a
 o

n
 1

 F
e
b
ru

a
ry 1

9
9
7
. D

o
w

n
lo

a
d
e
d
 fro

m
 

http://oem.bmj.com/