WHO Recent publications

IRecent publications WHO-OMS Publications recentes Bulletin of thc World Health Organization, 66 (2): 279-282 (1988) i World Health Organization 1988 Chemical toxicology, carcinogenicity Hydrazinea Geneva, 1987, 89 pages (Environmental Health Criteria, No. 68). ISBN 92 4 154268 3 Price: Sw.fr. 10.- /US$ 6.00 This report evaluates more than 200 published studies in an effort to determine the risks to human health and the environment posed by hydrazine, which is primarily used as a raw material in the manufacture of agricultural chemicals, blowing agents, polymerization catalysts, and pharmaceuti- cal products. The book opens with information on the physical and chemical properties of hydrazine, including a summary of analytical methods for its determination in air, water, blood, urine, drugs, and cigarette smoke. Other sections present infor- mation on world production of hydrazine, changing patterns of use, behaviour in the environment, effects on the ecosystem, and kinetics and metabo- lism, including reactions with body components. Noting that hydrazine poses few hazards for the general population, the section concerned with environmental levels and human exposure concen- trates on occupational risks at the workplace, in- cluding risks of exposure at production plants, at propulsion testing and rocket launching sites, and at locations where aircraft using hydrazine as an emergency fuel are assembled or refuelled. A re- view of acute toxicity data for aquatic organisms, microorganisms, and plants indicates that hydra- zine may present a significant hazard for the aquatic environment and plant life. The remaining sections evaluate specific health risks identified in experi- mental animal research, in in vitro test systems, and in case reports of accidental poisoning in man. Documented effects include damage to the central nervous system, liver and kidneys, skin and eye irritation, and skin sensitization. The results from animal studies further suggest that effects on man may include embryotoxicity and adverse effects on the respiratory system. Principles of studies on diseases of suspected chemical etiology and their preventiona Geneva, 1987, 79 pages (Environmental Health Criteria, No. 72). ISBN 92 4 154272 1 Price: Sw.fr. 9.-/US$ 5.40 This report gives investigators confronting a dis- ease of unknown etiology a logical, step-by-step strategy for tracing the possibility that a man-made or natural chemical is the cause. The strategy, which is divided into five progressive steps, is based on experiences indicating the value of a disease-oriented approach that differs, in several important ways, from classical methods used in predictive toxicology. Throughout the book, em- phasis is placed on the character and sequence of questions that will be of greatest help in deter- mining whether a chemical is implicated and then identifying the chemical. The book will serve as a practical and expert guide for any investigator who suspects that a chemical may be involved in the etiology of an episodic or endemic disease. Diaminotoluenesa Geneva, 1987, 67 pages (Environmental Health Criteria, No. 74). ISBN 92 4 154274 8 Price: Sw.fr. 9.-/US$ 5.40 The risks to human health and the environment posed by diaminotoluenes are evaluated in this book. Classed as toxic, highly irritant chemicals, diaminotoluenes are large-volume intermediates used in the production of a wide variety of industrial and consumer products, ranging from dyes and corrosion inhibitors to photographic developers. The most extensive section considers the design and findings of studies conducted in experimental ° Published byWHO under the joint sponsorship of the United Nations Environment Programme, the Intemational Labour Organisation, and WHO (Intemational Programme on Chemical Safety- IPCS). 279- 280 RECENT PUBLICATIONS animals and in vitro test systems. A review of toxic effects observed with different exposures is fol- lowed by an analysis of data demonstrating that diaminotoluenes impair spermatogenesis in experi- mental animals and are embryotoxic and terato- genic. Effects on man are evaluated on the basis of epidemiological studies of long-term occupational exposure, including assessment of reproductive hazards for males. Documented effects include severe dermatitis, blistering, and urticaria and, in the eye, lachrymation, corneal opacities, and permanent blindness, if untreated. Coughing, dyspnoea, and respiratory distress are associated with inhalation of fumes. On the basis of these findings, the book concludes that diaminotoluenes should be handled as hazardous chemicals and that preventive measures should be taken to avoid exposure of workers and to protect the environ- ment from pollution. Toluene diisocyanatesb Geneva, 1987, 72 pages (Environmental Health Criteria, No. 75). ISBN 92 4 154275 6 Price: Sw.fr. 9.-/US$ 5.40 In this volume, the methodology and findings of over 150 published studies are examined, in an effort to determine the risks to human health and the environment posed by the two isomers of toluene diisocyanate. These synthetic organic chemicals are important industrial intermediates used in conjunction with polyether and polyester polyols as co-reactants in the manufacture of poly- urethane foams, paints, varnishes, elastomers, and coatings. The book opens with an outline of the physical and chemical properties of toluene diiso- cyanates and a description of analytical methods for their detection in workplace air and in flexible foam. A section discussing sources of human and environmental exposure concentrates on occu- pational exposures associated with the very wide use of polyurethane foams in the automotive and furniture industries and in packing and insulation. Uses of polyurethane foam in furniture, bedding, carpet underlay, and refrigeration equipment are also considered as sources of domestic exposure. Other sections summarize what is known about the environmental fate of toluene diisocyanates and discuss their kinetics and metabolism in body fluids, including possible immunogenic actions. A section devoted to effects on experimental animals and in vitro test systems considers toxic effects observed for single exposures, short-term ex- posures, and long-term exposures via inhalation, dermal application, and oral gavage. In view of the b See footnote a on page 279. wide use of these compounds by a large number of workers, the section devoted to effects on man uses findings from epidemiological studies to document the extent and severity of gastrointesti- nal, neurological, ocular, dermal, and respiratory symptoms, including asthma and hypersensitivity pneumonitis. On the basis of available data, the book concludes that the isomers of toluene diiso- cyanate should be classified as very toxic com- pounds by inhalation, and that it should be treated as a potential human carcinogen and as a known animal carcinogen. Evaluation of certain food additives and contaminants Thirty-first report of the Joint FAO/WHO Expert Committee on Food Additives Geneva, 1987, 53 pages (WHO Technical Report Series, No. 759). ISBN 92 4 120759 0 Price: Sw.fr. 9.-/US$ 5.40 This report contains the findings and recommen- dations of a joint FAO/WHO committee commis- sioned to prepare specifications for the identity and purity of selected food additives and contami- nants and to undertake toxicological evaluations.c The main section summarizes available chemical, biological, and toxicological data on a number of food additives and contaminants that were either evaluated for the first time or re-evaluated by the committee. These include substances in the gen- eral categories of enzyme preparations, flavouring agents, food colours, a miscellaneous group of food additives, and aflatoxins. Readers are also notified of revisions in existing specifications or the establishment of new ones. Annexed to the report are three additional sections, including a bibliography of reports and documents, a table communicating the status of acceptable daily intakes and specifications issued for compounds considered by the committee, and a list of further toxicological studies and information required or desired for certain substances. Communicable diseases Control of lymphatic filariasis A manual for health personnel Geneva, 1987, 89 pages ISBN 92 4154217 9 Price: Sw.fr. 15.-/US$ 9.00 A technical manual designed to assist those who plan, manage and carry out filariasis control c The thirtieth report of the Joint FAO/WHO Expert Com- mittee on Food Additives (WHO Technical Report Series, No. 751) was reviewed in the Bulletin of the World Health Organization, 65 (4): 557 (1987). RECENT PUBLICATIONS programmes. Part 1 provides a succinct but thorough introduction to the epidemiological and clinical complexities of lymphatic filariasis, em- phasizing details and distinctions of practical importance to control programmes. Readers are given facts about the life-cycles of the parasites and the different types of infections they cause, including related differences in geographical dis- tribution, ecotypes, and microfilarial periodicity. An outline of the most important and widespread vectors concentrates on bionomic aspects relevant to control. Readers are also guided through the wide spectrum of clinical manifestations and given concise advice on available methods for detection and treatment. Instructions concerning the use of diethylcarbamazine citrate cover recommended dosages, side-reactions, and the results that can be expected from treatment, whether involving indi- vidual cases or the mass treatment of communi- ties. Part 2 describes a systematic approach for developing national control strategies that are community-oriented, simple, and economical. Main points include the definition of objectives, methods for parasite and vector control, treatment options, and a detailed list of suggested strategies specific to the size of the affected population and the level of endemicity. Part 3 describes a number of specific methods and techniques for collecting sound epidemiological data in a relatively short time. Details range from steps to follow in the prep- aration of blood films, through methods for the mass dissection of mosquitos, to tables and illus- trations that help differentiate the microfilariae of Maladies diarrheiques Traitement de la diarrhee et utilisation de la therapie par rehydratation orale (TRO) Document conjoint OMS/FISE Deuxibme 6dition Geneve, 1986, 27 pages ISBN 92 4 256086 3 Prix: Fr.s. 3.- Cette declaration conjointe OMS/FISE contient de nouvelles connaissances scientifiques et des renseignements pratiques concernant l'utilisation de la th6rapie par rehydratation orale, d6couverte technologique qui devrait contribuer a reduire la mortalite infantile imputable aux maladies diar- rheiques. Les differents chapitres traitent des ques- tions scientifiques, programmatiques et operation- nelles les plus importantes pour la mise au point et le renforcement des programmes nationaux de the three parasite species, their larval stages, and the worms. The book concludes with a tabular listing of the principal and subsidiary mosquito vectors of filarial parasites, presented according to filaria species, species type, and major endemic zone. The book will be of value to any planner or field worker who must understand the complexities of lymphatic filariasis in order to devise an effective programme for control. Guidelines for the development of a national AIDS prevention and control programme Geneva, 1988, 27 pages (WHO AIDS Series 1). ISBN 92 4 121001 X Price: Sw.fr. 8.-/US$ 4.80 The epidemic of AIDS (acquired immunode- ficiency syndrome) is a world health problem of extraordinary scale and extreme urgency. It repre- sents an unprecedented challenge to the public health services of the world. This book is the first in a series of publications to be produced by WHO with the aim of helping national authorities to meet this challenge. It provides information on the establishment and organization of a national pro- gramme for the prevention and control of AIDS, covering definition of programme objectives, development of strategies, identification of appro- priate activities, and evaluation of achievements and disease trends. lutte contre les maladies diarrheiques. La therapie par rehydratation orale pouvant 'tre utilisee dans 1'ensemble du systeme de sante, le rapport con- tient des renseignements pratiques concernant les principes de la therapie et son utilisation au niveau de la communaute, du foyer et des centres de traitement. Maladies transmissibles Lutte contre la fievre jaune en Afrique Geneve, 1987, v + 96 pages ISBN 92 4 256091 X Prix: Fr.s. 17.- Guide pratique et actualise destine aux mede- cins at aux fonctionnaires de la sante publique travaillant dans la zone d'endemie de la fibvrejaune en Afrique. Exceptionnellement complet, cet 281 282 PUBLICATIONS RECENTES ouvrage contient des informations sur tous les aspects du diagnostic, du depistage et du traite- ment necessaires pour une prise en charge efficace des pouss6es 6pidemiques de fieVre jaune. 11 opere 6galement une distinction entre trois schemas epi- demiques de la fievre jaune, caract6rises par leur cycle de transmission: la fievre jaune selvatique que l'homme contracte apres exposition, par l'interm6diaire de moustiques sauvages, a un cycle enzootique parmi les singes; une forme inter- mediaire qui associe les cycles de transmission d'homme a homme et de singe a singe; enfin, une forme a transmission interhumaine dans laquelle le virus est transmis par Aedes aegypti domestique. A ces trois cycles correspondent des zones epi- demiologiques distinctes, des mesures de sur- veillance, de prevention et de lutte appropriees etant present6es pour chacune. Etant donn6 l'im- portance de la vaccination comme strat6gie de prevention, l'ouvrage contient egalement des in- formations d6taillees sur la production de vaccins, les pratiques en mati'ere de vaccination, en evo- quant notamment la question delicate de l'age minimum auquel les nouveau-nes doivent etre vaccin6s et l'immunite et les complications post- vaccinales. 11 contient, en moins de 100 pages, une mine si riche d'informations sur tous les aspects de la maladie, qu'il est aussi un outil de ref6rence essentiel pour les etudiants en medecine et les enseignants, les epid6miologistes et les cliniciens, et cela pas seulement en Afrique.d Guide pour la mise en place d'un programme national de lutte contre le SIDA Genbve, 1988, 30 pages (Serie OMS SIDA 1). ISBN 92 4 221001 3 Prix: Fr.s. 8.- L'epid6mie de SIDA (syndrome d'immunode- ficience acquise) constitue un probleme de sante mondial d'une ampleur extraordinaire et d'une urgence extreme et repr6sente un defi sans pre- c'dent pour les services de sante publique du monde entier. Le present ouvrage est le premier d'une s6rie que doit publier l'OMS dans le but d'aider les autorit6s nationales a relever ce defi. 11 fournit des informations sur l1etablissement et l'organisation d'un programme national de lutte d Une note sur la fibvre jaune en 1986 a paru dans le Bulletin de l'Organisation mondiale de la Sant6, 66 (1): 129-130 (1988). contre le SIDA et couvre la definition des objectifs du programme, la formulation de strategies, l'iden- tification des activites appropriees et I evaluation des realisations et des tendances de la maladie. Produits biologiques, preparations pharmaceutiques Tests simplifies pour les substances pharmaceutiques Geneve, 1987, 210 pages ISBN 92 4 254204 0 Prix: Fr.s. 34.- Ce livre presente des tests simplifies pour veri- fier l'identite des substances pharmaceutiques et deceler toute degradation importante. Les 321 sub- stances couvertes representent la majorite des substances pharmaceutiques contenues dans la liste modele OMS des medicaments essentiels ' et un certain nombre de substances communement utilisees. Pour chacune, des tests ont ete mis au point pour permettre de verifier l'identit6 de la substance en l'absence d'un laboratoire entiere- ment 6quip6 au moyen d'une methode simple et facile d'emploi. C'est pourquoi les reactifs et le materiel requis on ete maintenus a un minimum et les reactifs instables, corrosifs, couteux ou difficiles a se procurer ont ete exclus. On a accorde une attention particuliere aux techniques visant a determiner les caracteristiques de fusion car elles permettent non seulement de confirmer l'identite d'une substance mais aussi de deceler toute conta- mination possible, qu'elle provienne de mauvaises conditions de fabrication, d'une adulteration, d'une contamination croisee en cours de stockage ou d'une degradation. L'ouvrage se termine par une liste du materiel requis et une description des reachifs, solutions de reactifs et solutions titrees necessaires a la r6alisation des tests simplifies. Les methodes de preparation des solutions de reactifs qui exigent une attention particuliere sont exposees de fa9on detaillee. Ce livre sera un ins- trument utile pour les programmes nationaux d'assurance de la qualite au sein du systeme de distribution pharmaceutique. ' Voir OMS, S6rie de Rapports techniques, NO 722, 1985 (L'utilisation des m6dicaments essentiels (liste mod*le des m6dicaments essentiels, quatri6me r6vision): deuxi&me rapport du Comit6 d'Experts de l'OMS).