Recent WHO publications

Recent WHO publications/Publications recentes OMS Cardiovascular diseases Prevention In childhood and youth of adult cardiovascular diseases: time for action Report of a WHO Expert Committee Geneva, 1990, 105 pages (WHO Technical Report Series, No. 792). ISBN 92 4 120792 2 Price: Sw.fr. 12.-/US$ 9.60 Throughout this report, an effort is made to translate scientific knowledge about the causes of cardio- vascular diseases into clear lines of preventive action, applicable in early life, that can be followed by parents, schools, physicians, public health authorities, and governments. Drawing upon decades of experimental, clinical, and epidemiological research, the report presents convincing evidence that the processes lead- ing to cardiovascular disease start in childhood, that causative factors are directly linked to culturally- determined risks, and that correction or avoidance of these risks needs to be an integral component of childhood preventive care. Chemical toxicology, carcinogenicity Evaluation of certain veterinary drug residues In food Thirty-fourth report of the Joint FAO/WHO Expert Committee on Food Additives Geneva, 1989, 66 pages (WHO Technical Report Series, No. 788). ISBN 92 4 120788 4 Price: Sw.fr. 9.-/US$ 7.20 This report presents the conclusions of an expert committee convened to evaluate the safety of residues of certain veterinary drugs in foods and to recommend maximum levels for such residues. The first part of the report contains a discussion on the biological impact of veterinary drug residues bound to cellular constituents in animal tissues and of other factors, including bioavailability, that influence the setting of maximum residue levels for foods. The second section summarizes evaluation of toxicological and residue data on specific veterinary drugs. Annexed to the report are the committee's recommendations on these compounds, including acceptable daily intakes for humans and maximum residue levels, a list of further information required or desired, and details of a procedure for calculating daily intakes of residues.8 Evaluation of certain food additives and contaminants Thirty-fifth report of the Joint FAO/WHO Expert Committee on Food Additives Geneva, 1990, 48 pages (WHO Technical Report Series, No. 789). ISBN 92 4 120789 2 Price: Sw.fr. 6.-/US$ 4.80 This report, which contains the conclusions of an expert committee commissioned to conduct system- atic toxicological evaluations of food additives and contaminants in food, also presents specifications for the identity and purity of food additives in order to make certain that the materials subjected to toxico- logical testing are adequately defined and correspond to the products in commerce. Readers are introduced to several general concerns that governed the com- mittee's revision of specifications for selected enzyme preparations, naturally occurring substances, and sol- vent residues. The main part of the report summarizes evaluations of toxicological data on selected emul- sifiers, enzymes, flavouring agents, food colours, thick- ening agents, other additives, and the contaminants patulin and polychlorinated biphenyls (PCBs). The report concludes with a table summarizing recommended daily intakes and listing changes in the status of specifications for substances considered by the committee. A final table lists further toxicological studies required or desired.' Toxicological evaluation of certain veterinary drug residues In food prepared by the 34th Meeting of the Joint FAO/WHO Expert Committee on Food Additives (JECFA) Geneva, 1990, vii + 168 pages (WHO Food Additives Series, No. 25). Price: Sw.fr. 22.-/US$ 17.60 Toxicological evaluation of certain food additives and contaminants prepared by the 35th Meeting of the Joint FAO/WHO Expert Committee on Food Additives (JECFA) Geneva, 1990, vii+ 189 pages (WHO Food Additives Series, No. 26). Price: Sw.fr. 22.-/US$ 17.60 ' The toxicological and related data that served as the basis for the committee's evaluations are published separately as volumes No. 25 and 26 in the WHO Food Additives Series (see following reviews). Bulletin of the World Health Organization, 68 (5): 683-6 (1990) 683 Recent WHO publications Published since 1972, the WHO Food Additives Series serves as a record of the extensive toxicological data assessed by the Joint FAO/WHO Expert Committee on Food Additives when establishing acceptable daily intakes for intentional food additives and tolerable intakes for contaminants. Each volume concentrates on a selection of additives and contaminants, provid- ing fully referenced evaluations of all biological and laboratory data relevant to safety assessment. Over the years, volumes in the series have come to be respected as authoritative reference works of particu- lar value to industries producing and using food additives, food regulatory offices, industrial testing laboratories, toxicological laboratories, and univer- sities. Communicable diseases Prevention of sexual transmission of human Immunodeficiency virus Geneva, 1990, iii+27 pages (WHO AIDS Series 6). ISBN 92 4 121006 0 Price: Sw.fr. 8.-/US$ 6.40 This book gives a brief overview of what is known about the modes of HIV transmission, and a detailed explanation of factors influencing the risk of acquiring HIV infection through sexual intercourse. It then presents guidelines for prevention through education, the promotion and supply of condoms and spermi- cides, the use of HIV antibody tests and counselling, and partner notification. Specific recommendations are given for actions to be taken by public health authorities and other groups involved in AIDS pre- vention as part of the national AIDS programme. Guidelines on AIDS and first aid In the workplace Published by WHO in collaboration with the International Labour Office and the League of Red Cross and Red Crescent Societies Geneva, 1990, iii + 12 pages (WHO AIDS Series 7). ISBN 92 4 121007 9 Price: Sw.fr. 4.-/US$ 3.20 The guidelines published in this book contain general information on the transmission of the human im- munodeficiency virus (HIV) and specific information on risks associated with first aid treatment of injured employees. Topics include mouth-to-mouth resuscita- tion, treatment of bleeding, the cleaning up of spilt blood, and the immediate steps to be taken when a first-aid worker is exposed to blood. The guidelines also reassure first-aid workers that the risk of acquir- ing infection during mouth-to-mouth resuscitation and the management of bleeding is very low and should not be used as a reason to withhold life-saving procedures. The book concludes with a consensus statement on AIDS and the workplace, including advice on the development of employment policies. Progress in assessment of morbidity due to schistosomiasis Reviews of recent literature by M.G. Chen & K.E. Mott Geneva, 1989, 155 pages ISBN 0 9510869 4 4 Price: Sw.fr. 20.-/US$ 16.00 This publicationb gives public health workers, medical educators, and specialists in paediatrics and internal medicine a guide to the complex pathological features, clinical signs and symptoms, side-effects, long-term complications, including carcinogenic risk, and rec- ommended treatment for the different forms of schisto- somiasis. Advice and conclusions are issued on the basis of a critical review of the design and findings of close to 1000 research reports, mostly published during the past ten years. An effort is made to identify points of controversy or consensus that can guide future investigations and assist in the development of better techniques for control. Separate reviews are presented for Schistosoma haematobium, S. intercalatum, S. japonicum, and S. mansoni. These reviews were prepared as a follow-up to the recommendations of aWHO expert committee on the control of schistosomiasis,c which identified the need for systematic reporting of morbidity due to schistosomiasis as a critical component of the global strategy for controlling this disease. Epidemiology, statistics World health statistics annual 1989 Geneva, 1989, xxvi + 441 pages ISBN 92 4 067890 5 Price: Sw.fr. 90.-/US$ 72.00 The World health statistics annual presents global statistical information designed to provide both coun- b Reprinted from: Tropical diseases bulletin, Vol. 85, 1988, No. 6 & 10, and Vol. 86, 1989, No. 4 & 8. c The control of schistosomiasis: report of a WHO Expert Com- mittee. Geneva, 1985 (WHO Technical Report Series, No. 728). saM WHO Bulletin OMS. Vol. 68 1990. Recent WHO publications try and global overviews of changing trends in health status and in causes of death. Statistics, which are submitted to WHO by national health and statistical offices, are critically assessed in an effort to help countries identify health problems and interpret changes over time. Topics covered in 1989 include trends and pro- jections of infant and child mortality, the major causes of infant and child deaths, and various indicators of accessibility to health care services. The second section presents the first results of the WHO MONICA project, an international collaborative study launched by WHO to monitor trends and determinants of cardiovascular diseases. Apart from confirming the importance of high cholesterol, elevated blood pres- sure, overweight, and smoking as major risk factors, these first results reveal striking contrasts in mortality rates between different countries, underscoring the need to search for better preventive strategies. Tables in the third section summarize the demographic situation of countries in terms of those parameters likely to be of greatest relevance for health manage- ment. The final and most extensive section consists of a series of tabular statistics on causes of death, by sex and by age. For the first time, comprehensive cause-of- death statistics for China are included. Maternal, child and adolescent health Injectable contraceptives Their role In family planning care Geneva, 1990, x+117 pages ISBN 92 4 154402 3 Price: Sw.fr. 21.-/US$ 16.80 Thoroughly grounded in research as well as practical experience, this book concentrates on the facts and advice needed to help service managers understand what the decision to offer injectables means in terms of both demands on staff and services and the health and welfare of clients. Emphasis is placed on the safe and effective use of depot-medroxyprogesterone acetate (DMPA) and norethisterone enantate (NET- EN), the most widely used injectables currently licensed in some 100 countries. In view of the risk of HIV transmission through injections, the book issues explicit instructions for the sterilization of needles and syringes, the correct tech- niques for performing injections, the safe use of disposable needles and syringes, and steps needed to avoid dangerous mistakes. Five annexes list the coun- tries and territories where DMPA and NET-EN are registered, identify international sources of technical and funding assistance, give the names and addresses of the principal manufacturers, explain how to calcu- late the equilibrium level in the number of users, and list the indicators for the evaluation of services. Community participation in maternal and child health/family planning programmes An analysis based on case study materials S.B. Rifkin Geneva, 1990, ix+38 pages ISBN 92 4 156135 1 Price: Sw.fr. 9.50/US$ 7.60 Addressed to health planners, this book concentrates on questions of management and human behaviour that need to be considered when planning health programmes based on the concept or methods of community participation. Throughout the book, numerous case studies are used to develop an ana- lytical framework for understanding why such pro- grammes so often fail to reach their goals. The analytical framework for the study is also developed, describing programmes on the basis of their objectives and the ways in which those objectives are pursued. Five different levels of participation are identified. The author suggests that the progress and success of a programme are governed by descriptive factors, which are mainly of an environmental nature, and action factors, which refer to organization, management, and resource mobilization. Arguing that descriptive fac- tors are especially difficult to change, the author con- centrates on six specific action factors and then shows how each factor may operate to favour or hinder effective community involvement. Occupational health Occupatlonal health services: an overview edited by J. Rantanen Copenhagen, WHO Regional Office for Europe, 1990, ix + 48 pages (WHO Regional Publications, European Series, No. 26). ISBN 92 890 1117 3 Price: Sw.fr. 10.-/US$ 8.00 Occupational health services began in Europe more than 100 years ago. They were a response to needs created by industrialization, and have developed in accordance with the legal, political and social condi- tions and traditions in each country. This book is the result of a groundbreaking study of these services throughout the European Region, and is based on WHO Bulletin OMS. Vol. 68 1990. on5 Recent WHO publications countries' own descriptions of their services and on information from international agencies and experts. It summarizes the principles and functions of occu- pational health services in the 32 Member States of the Region, describing their legislative basis, admin- istrative agencies, objectives, activities, organiza- tional models, coverage, personnel, and links with other kinds of service and support systems. The book concludes with a look at current problems and expec- tations for the future. Official publications, annual reports The work of WHO 1988-1989 Biennial report of the Director-General to the World Health Assembly and to the United Nations Geneva, 1990, xiii + 265 pages ISBN 92 4 156133 5 Price: Sw.fr. 45.-/US$ 36.00 This book provides a critical appraisal of the work of WHO during the 1988-1989 biennium. Analytical in its approach, the book serves as both a record of specific activities of WHO and an evaluation of the extent to which these activities are supporting the overriding health-for-all strategy. Highlights include intensified efforts to improve world nutrition and environmental health, increased emphasis on drug management and policies, and continuing concern with vaccine development and the transfer of health care technology. The report also covers progress in the immunization of the world's children and con- siders prospects for reaching the ambitious new goal of poliomyelitis eradication before the end of this century. International Agency for Research on Cancer Biennial report 1988-1989 Lyon, International Agency for Research on Cancer, 1989, xix+246 pages ISBN 92 832 1089 1 Price: Sw.fr. 15.-/US$ 12.00 In keeping with the Agency's objectives, this report for 1988-89 illustrates the diversity of epidemiological and experimental studies being carried out in order to improve knowledge about the prevention of cancer in man. The biennium saw the successful development of several projects as well as the inception of new ones. Detailed descriptions are given in five main sections of the report: -studies on etiology and prevention (geographical distribution, environmental and occupational hazards, nutrition, genetics, cancer screening, etc.); -studies on mechanisms of carcinogenesis (role of viruses, oncogenes, DNA damage, perinatal carcinogenesis, etc.); -data collection and research methods (cancer reg- istries, statistical methodology, etc.); technical support (computing, bibliographic and laboratory services); -education and training (research fellowships and training courses). Other useful information is presented in a series of annexes. A full bibliography of IARC publications (Monographs series, Scientific Publications series, etc.) is given at the end. Pharmaceuticals, biologicals WHO Expert Committee on Specifications for Pharmaceutical Preparations Thirty-first report Geneva, 1990, 79 pages (WHO Technical Report Series, No. 790). ISBN 92 4 120790 6 Price: Sw.fr. 9.-/US$ 7.20 This book records the recommendations and con- clusions of an expert committee concerned with the need to assist drug control laboratories and regulatory authorities in the quality control of pharmaceutical preparations. It has two main parts. The first serves as a brief alert to a number of technical developments and practical problems pertinent to the operation of quality control laboratories, such as the quality as- surance of products manufactured by recombinant DNA technology, the inability of stability data com- piled in temperate countries to predict shelf-life in tropical climates, and the special problems created by falsely labelled, spurious, counterfeited, and sub- standard pharmaceuticals. The second part consists of six sections devoted to: the problem ofdrug stability; sampling procedures for industrially manufactured pharmaceuticals; guidance for those preparing or commenting on monographs for preparations to be included in The International Pharmacopoeia, the list of available International Chemical Reference Sub- stances (1988), and the WHO Certification Scheme on the Quality of Pharmaceutical Products Moving in International Commerce; and guiding principles to assist small national drug regulatory authorities in the development of a reliable technical and administrative system for the licensing of pharmaceutical products. WHO Bulletin OMS. Vol. 68 1990.68B Publications r4centes OMS Epidemlologle, statistiques Annualre de statistiques sanitaires mondlales 1989 Gen6ve, 1989, xxvi+441 pages ISBN 92 4 067890 5 Prix: Fr.s. 90.- L'Annuaire de statistiques sanitaires mondiales con- tient des informations statistiques conques de maniere a donner une idee de l'evolution des tendances de la situation sanitaire et des causes de mortalite, tant dans les pays qu'a l'echelle mondiale. Ces statistiques, adressees a l'OMS par les services nationaux de sante et de statistique, sont soumises a un examen critique pour aider les pays a identifier leurs problemes de sante et a interpreter les changements qu'ils observent. Parmi les sujets retenus pour 1989 figurent les tendances et projections de la mortalite infantile et juvenile, les principales causes des deces infantiles et juveniles et divers indicateurs de l'accessibilite des services de soins de sante. La deuxieme section donne les premiers resultats du projet MONICA de l'OMS, etude collective internationale lancee par l'OMS pour surveiller les tendances et les determinants des mala- dies cardio-vasculaires. Outre qu'ils confirment l'im- portance, parmi les principaux facteurs de risque, d'un fort taux de cholesterol, d'une pression arterielle elevee, de l'obWsite et de l'usage du tabac, ces premiers resultats font apparaitre des differences frappantes entre les taux de mortalite de differents pays, ce qui fait ressortir la necessite de rechercher de meilleures strategies preventives. Les tableaux de la troisieme section resument la situation demographique des pays en se basant sur les parametres qui peuvent presenter le plus d'interet pour les gestionnaires de la sante. La derniere section, qui est aussi la plus etendue, com- porte une serie de tableaux statistiques sur les causes de deces par sexe et par age. Pour la premiere fois, on y a fait figurer des statistiques completes des causes de deces pour la Chine. Maladies cardio-vasculaires La prevention des le Jeune age des maladies cardio-vasculaires de I'adulte: 11 est temps d'agir Rapport d'un Comite OMS d'Experts Geneve, 1990, 117 pages (OMS, Serie de Rapports techniques, No 792). ISBN 92 4 220792 6 Prix: Fr.s. 12.- Tout au long de ce rapport, on s'est attache a traduire les connaissances scientifiques sur l'etiologie des mala- dies cardio-vasculaires en directives claires pour une action preventive applicable des le jeune age qui puissent etre observees par les parents, les educateurs, les medecins, les autorites de la sante publique et les gouvernements. En s'appuyant sur des d6cennies de recherches experimentales, cliniques et epidemio- logiques, le rapport montre de faqon convaincante que le processus qui aboutit aux maladies cardio-vas- culaires plonge ses racines dans l'enfance, que les facteurs etiologiques sont directement lies a des risques decoulant de la culture et que les mesures prises pour eviter ces risques ou y remedier doivent faire partie integrante de soins preventifs dispenses a l'enfant. Medecine radiologique Assurance de qualite en radlotheraple Geneve, 1990, 56 pages ISBN 92 4 254224 5 Prix: Fr.s. 11.- Prepare par un groupe de 35 experts internationaux venus de 15 pays, cet ouvrage met en relief la multitude de facteurs qui conditionnent la bonne pratique en radiotherapie et constitue un guide pratique pour les travaux particuliers qu'implique l'assurance de qualite. Une attention particuliere est pretee a l'urgente necessite d'encourager une certaine uni- formit& dans la qualite des services de radiotherapie et la coherence des resultats therapeutiques obtenus, que ce soit a l'h6pital, au niveau national ou international. La premiere partie du livre indique quelles sont les composantes essentielles de l'assurance de qualite, et donne des renseignements sur la nature des pro- grammes d'assurance de qualite en radiotherapie, les responsabilites du personnel et des fabricants d'equipe- ment, le r6le de la legislation et de la reglementation, ainsi que la formation necessaire des differentes cate- gories de personnel. Les aspects physiques et tech- niques sont traites dans la deuxieme partie, ou' le lecteur trouvera des renseignements detailles sur l'essai et le contr6le de l'equipement, et notamment des recommandations sur la frequence de ces contr6les destines a garantir la delivrance de doses uniformes et precises pour le traitement. L'ouvrage conclut par un expose des aspects cliniques de l'assurance de qualite, allant de l'enregistrement approprie des malades a l'evaluation des resultats du traitement. Publications officielles, rapports annuels Activite de l'OMS 1988-1989 Rapport blennal du Directeur g6n6ral WHO Bulletin OMS. Vol. 68 1990. 687 Publications rbc.ntes OMS A i'Assembi4e mondiale de la Sant6 et aux Nations Unies Gen6ve, 1990, xiii+289 pages ISBN 92 4 256133 9 Prix: Fr.s. 45.- Cet ouvrage est une analyse critique de l'activite de l'OMS pendant la periode biennale 1988-1989. Apres avoir decrit certaines des activites de l'Organisation, il tente de determiner dans quelle mesure elles soutien- nent la strategie fondamentale de la sante pour tous. Sont notamment mis en lumiere les efforts accrus deployes pour ameliorer la nutrition dans le monde et l'hygiene de l'environnement, l'accent mis sur les politiques de gestion des medicaments, le souci con- stant de mise au point de vaccins et le transfert de techniques de soins de sante. Le rapport fait egalement le point du programme mondial de vaccination des enfants et s'interroge sur les possibilites qui existent d'atteindre ce nouvel objectif ambitieux qu'est l'era- dication de la poliomyelite avant la fin du siecle. Centre International de Recherche sur ie Cancer Rapport blennal 1986-1989 Lyon, Centre international de Recherche sur le Cancer, 1989, xxi +270 pages ISBN 92 832 2089 7 Prix: Fr.s. 15.- Conformement aux objectifs du Centre, le rapport sur son activite en 1988-1989 met en lumiere les diverses etudes epidemiologiques et experimentales menees afin de mieux connaitre la prevention du cancer chez l'homme. Au cours de la periode biennale consideree, divers programmes ont ete mis en ceuvre avec succes et de nouveaux projets ont ete lances. Des descriptions detaillees sont presentees dans les cinq grands chapitres du rapport: -etudes sur l'etiologie et la prevention (distribution geographique, risques environnementaux et pro- fessionnels, nutrition, genetique, depistage du cancer, etc.); -etudes sur les mecanismes de la cancerogenese (role des virus et des oncogenes, lesions et reparation de l'ADN, cancerogenese perinatale, etc.); -collecte des donnees et methodes de recherche (registres du cancer, methodes statistiques, etc.); -appui technique (services de calcul, de bibliotheque et de laboratoire); -enseignement et formation (bourses et cours de formation a la recherche). D'autres informations utiles sont presentees dans une serie d'annexes, tandis qu'une bibliographie com- plete des publications du Centre (series de mono- graphies et de publications scientifiques, etc.) termine le rapport. Sante maternelle et infantile, sante des adolescents La prevention des deces maternels par E. Royston & S. Armstrong Geneve, 1990, 230 pages ISBN 92 4 256128 2 Prix: Fr.s. 40.- Ce livre explore les facteurs nombreux et complexes qui sont 'a l'origine du nombre considerable des dec's maternels qui peuvent etre prevenus et continuent pourtant de se produire chaque annee. Sur la base de plus de 400 references a la litterature, cet ouvrage expose la gamme des problemes-du fatalisme aux lacunes des services de sante en passant par les coutumes sociales-qu'il importe de comprendre pour apporter l'attention voulue aux besoins particuliers et si longtemps negliges des femmes en matiere de sante. II se termine par un appel a l'action en soulignant que des mesures preventives simples et peu cofiteuses peuvent avoir un impact majeur sur les dce's et les souffrances si longtemps consideres comme indis- sociables de la maternite. Toxicologie des substances chimiques, carcinogenicite Evaluation des residus de certains m6dicaments veterinalres dans les ailments Trente-quatri6me rapport du ComitA mixte FAO/OMS d'Experts des Additlfs allmentaires Geneve, 1989, 70 pages (OMS, Serie de Rapports techniques, No 788). ISBN 92 4 220788 8 Prix: Fr.s. 9.- Ce rapport presente les conclusions d'un comite d'experts charge d'evaluer la securite des residus de certains medicaments veterinaires dans les aliments et d'etablir les concentrations maximales admissibles de tels residus. La premiere partie du rapport contient une discussion sur l'impact biologique des residus de medicaments veterinaires lies aux constituants cellu- laires des tissus animaux et d'autres facteurs, tels que les residus biodisponibles, qui influencent le calcul des WHO Bulletin OMS. Vol. 68 1990.m8 Publications r6centes OMS limites maximales de residus dans l'alimentation. La deuxieme partie resume l'evaluation toxicologique et les donnees relatives aux residus de certains medica- ments veterinaires. En annexe, le rapport comprend les recommandations du comite sur ces substances, y compris les doses joumalieres admissibles pour l'homme et les niveaux de residus maximum, une liste de donnees souhaitables ou necessaires, et des details sur un procede de calcul des apports journaliers de residus. Niveaux d'lntervention derives pour les radionucleldes dans les ailments Mesures recommand6es en cas de contamination radioactive 4tendue par suite d'un accident radiologlque majeur Gen6ve, 1990, 60 pages ISBN 92 4 254 233 4 Prix: Fr.s. 11.- A la suite de l'accident nucleaire de Tchernobyl en 1986, de nombreux pays ont ete victimes d'une con- tamination radioactive etendue. II est clairement ap- paru que les recommandations sur la conduite a tenir apres un accident nucleaire etaient inadaptees, tant en ce qui concerne les consequences a long terme que les regions eloignees du lieu de l'accident. On s'est particulierement preoccupe des denrees alimentaires et de l'eau de boisson contaminees a distance du lieu de l'accident. C'est pour repondre a cette preoccupa- tion que l'OMS a prepare les presentes recommanda- tions en se souciant avant tout de proteger la sante. Pour les differentes categories de denrees alimen- taires, on trouvera des recommandations relatives aux niveaux de contamination par les radionucleides qui justifieraient une action corrective visant a reduire les risques pour la sante de la population. Ces recom- mandations sont fondees sur des criteres reconnus de dose d'irradiation, sur les donnees de la consomma- tion alimentaire dans les differentes regions du monde et sur les donnees dosimetriques relatives aux radio- nucleides en cause. Elles ont pour objectif d'aider les responsables a prendre les decisions necessaires au niveau national au cas ou' surviendrait un autre accident nucleaire majeur. WHO Bulletin OMS. Vol. 68 1990. 1g89