Recent WHO publications

Recent WHO publications/Publications r6centes OMS Chemical toxicology, carcinogenicity Allethrlns- Allethrin, d-allethrln, bloallethrln, s-bloallethrln' Geneva, 1989, 75 pages (Environmental Health Criteria, No. 87). ISBN 92 4 154287 X Price: Sw.fr. 10.-/US$ 8.00 The four synthetic pyrethroid pesticides evaluated in this book are used mainly for the control of ffies and mosquitos in the home, flying and crawling insects on farm animals, and fleas and ticks on dogs and cats. Common formulations include aerosols and sprays, dusts and powders, smoke coils, and electric mats. Because these allethrins are most commonly used indoors, and since these compounds are rapidly decomposed by sunlight, the report concludes that the use of allethrins is unlikely to pose an environ- mental hazard, except in the case of spillage or misuse. Under recommended conditions of use, the exposure of the general population is judged negli- gible. The report also concludes that, with reasonable work practices, hygienic measures, and safety precau- tions, the use of allethrins is not likely to pose an occupational hazard. Dlmethoatea Geneva, 1989, 85 pages (Environmental Health Criteria, No. 90). ISBN 92 4 154290 X Price: Sw.fr. 12.-/US$ 9.60 This book evaluates the risks to human health and the environment posed by dimethoate, an organo- phosphorus insecticide widely produced and used to control a range of insects and mites. Information on physical and chemical properties and on methods used for detection and analysis is given. The book ' Published by WHO under the joint sponsorship of the United Nations Environment Programme, the International Labour Organisation, and WHO (International Programme on Chemical Safety-IPCS). also describes the sources of human and environmen- tal exposure, explains the behaviour of dimethoate in the environment, and summarizes what is known about the mechanisms by which this insecticide exerts its toxic effects. Concerning sources of occupational exposure, an effort is made to define the minimum safe re-entry periods following spraying in greenhouses, and after outdoor application by tractor or plane. A review of the effects of dimethoate for- mulations on organisms notes the low risk to farm animals, the moderate toxicity for birds, fish, and aquatic organisms, and the very high toxicity for honey bees. The most extensive section reviews the design and findings of experimental studies useful in assess- ing adverse effects on human health, and health risks are defined through a review of case studies of accidental and suicidal poisoning and of poisoning following occupational exposures. The book con- cludes that, when dimethoate is used under proper conditions, exposure of the general population through air, food, or water is negligible. Concerning occupational hazards, exposure during the manufac- ture, formulation, use, and disposal of dimethoate does not pose an unacceptable human health hazard, provided appropriate safety precautions are observed. Aldrin and dleldrlna Geneva, 1989, 335 pages (Environmental Health Criteria, No. 91). ISBN 92 4 154291 8 Price: Sw.fr. 34.-/US$ 27.20 This volume reviews the vast body of data on aldrin and dieldrin in an effort to determine whether the continuing, though restricted, use of these chemicals poses a hazard to health or the environment. An effort is made to determine whether previously high levels of use left persistent risks. Well over 900 studies are examined in order to unravel the complexities of the behaviour of these chemicals, resolve inconsisten- cies in reported results, and issue clear guidelines for the protection of human health and the environment. Bulletin of the World Health Organization, 66 (4): 523-528 (190) 523 Recent WHO publications Resmethrins- Resmethrln, bloresmethrln, cisresmethrin' Geneva, 1989, 79 pages (Environmental Health Criteria, No. 92). ISBN 92 4 154292 6 Price: Sw.fr. 10.-/US$ 8.00 These three synthetic pyrethroid pesticides are com- monly used for the indoor control of household insects, for mosquito control, and for white fly con- trol on greenhouse-grown vegetables. As bioresmeth- rin is also used as a post-harvest treatment to control pests in stored grain, particular concern centres on the possibility that residues in grain foods may pose a hazard to human health. Since resmethrins are most commonly used in aerosol formulation, particular attention is given to the possible adverse effects of exposure through inhalation. Studies conducted in in vitro test systems are examined in an effort to define the risks of mutagenicity, effects on reproduction, immunotoxicity, and neurotoxicity. No carcinogenic, mutagenic, or teratogenic effects have been demon- strated. Because resmethrins undergo rapid degradation in soil and on plants, the book concludes that residues will not persist in the environment or impair the safety of greenhouse vegetables. Though the use of resmethrin on stored grain may result in dietary exposure, the levels are not likely to exceed the established acceptable daily intake. The report also concludes that the high toxicity for fish demonstrated in laboratory studies is unlikely to cause a problem under field conditions, due to the low water solubility of resmethrins and their rapid degradation. Chlorophenols other than pentachlorophenol8 Geneva, 1989, 208 pages (Environmental Health Criteria, No. 93). ISBN 92 4 154293 4 Price: Sw.fr. 22.-/US$ 17.60 Chlorophenols are biocides effective against a large number of organisms, including bacteria, algae, molluscs, acarids, fungi, and moulds. Although agricultural use is now restricted in a number of countries, chlorophenols continue to be widely applied in wood treatment and preservation and in the surface treatment of freshly cut logs and lumber. Smaller amounts are also used as additives to inhibit microbial growth in a range of products, including adhesives, oils, textiles, and pharmaceutical drugs. While the degree of carcinogenic risk could not be determined, the report identifies the main symptoms of occupational exposure such as irritation of the eye, nose and airway, dermatitis, chloracne, porphyria, abnormal liver function tests, changes in brain wave activity, and slowed visual reaction time. The book concludes with a series of recommendations concern- ing the production and disposal of chlorophenols and the measures needed to protect workers and the general public. Some organic solvents, resin monomers and related compounds, pigments and occupational exposures In paint manufacture and painting Lyon, International Agency for Research on Cancer, 1989, 535 pages (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 47). ISBN 92 832 1247 9 Price: Sw.fr. 85.-/US$ 68.00 The first half of this book presents separate mono- graphs for six organic solvents, one solvent stabilizer, three resin monomers and modifiers, and two pig- ments. Each monograph opens with a presentation of basic physicochemical data useful in interpreting the results of different experimental studies. Information on worldwide production, industrial applications, and routes of exposure is followed by a critical evaluation of all biological data relevant to the assessment of carcinogenic risks in humans. In view of weaknesses in currently available data, the majority of these substances could not be classified in terms of carcinogenic risk. The second half of the book provides a detailed assessment of the likelihood that occupational exposures in paint manufacture and painting can cause cancer in humans. The most extensive section assesses the design and findings of epidemiotogical studies of carcinogenicity in the paint trade, including data suggesting an increased risk for cancers at several sites, for leukaemia, and for cancer in children associated with parental exposure. On the basis of the assessment, the book concludes that occupational exposure as a painter causes a significant increase in the risk of several cancers. Other adverse effects on health noted include allergic and nonallergic contact dermatitis, chronic bronchitis and asthma, and adverse effects on the nervous system. The cancer risk associated with occupational exposure in paint manufacture could not be classified on the basis of available data. WHO Bulletin OMS. Vol. 68. 1990524 Recent WHO publications Epidemiology Manual of epidemiology for district health management edited by J.P. Vaughan & R.H. Morrow Geneva, 1989, viii+196 pages ISBN 92 4 154404 X Price: Sw.fr. 35.-/US$ 28.00 This manual fills the need for a simple, practical, step-by-step guide to the use of epidemiology as a tool for improving the management of health ser- vices. Addressed to general health workers, the book uses clear definitions, analogies, examples, checklists, sample forms and calculations, and abundant illus- trations to demystify the methods of epidemiology and show how they can work in concrete situations. Particular emphasis is placed on the simple knowledge and skills needed to collect and use epidemiological data to monitor health problems commonly found in developing countries. Health education Food, environment and health A guide for primary school teachers T. Williams, A. Moon, & M. Williams Geneva, 1990, xix+ 129 pages ISBN 92 4 154400 7 Price: Sw.fr. 26.-/US$ 20.80 This book gives educators a highly practical collec- tion of facts, advice, projects, games, illustrations, stories, and sample questions for use in teaching children the importance of healthy habits, parti- cularly concerning food, personal hygiene and the home environment. Details range from advice on how to start a school garden or design a class growth chart to instructions for a game of "germ warfare" that illustrates how pathogens invade the human body. Throughout, emphasis is placed on simple, imaginative tools for correcting errors of food safety, nutrition, and personal hygiene commonly found in developing countries. Specialized medical education In the European Region edited by J.P. Parkhouse & J.-P. Menu Copenhagen, WHO Regional Office for Europe, 1989, x+256 pages (EURO Reports and Studies, No. 112). ISBN 92 890 1278 1 Price: Sw.fr. 18.-/US$ 14.40 Does medical education produce the sort of doctors we need? Do we know what we need? Do we know how to go about getting it? This report, which analyses the training patterns for the main medical specialties in every country in Europe, will be a most valuable tool in the search for answers to these questions. The course length and other selected requirements are presented in tabular form, first country by country, then specialty by specialty, to enable direct comparisons to be made. A descriptive section country by country enables the reader to put the tabular information into context and avoid draw- ing spurious conclusions. The overall trend is clear. Countries are trying to relate their specialist cur- ricula to the health problems in the community, and general practice is becoming recognized as a special- ty in its own right. This is an invaluable source book for all those involved in the training of medical specialists: graduates themselves, medical schools, specialists, medical associations, and health services. Substance abuse Alcohol and the mass media J. Partanen & M. Montonen Copenhagen, WHO Regional Office for Europe, 1988, 73 pages (EURO Reports and Studies, No. 108). ISBN 92 890 1274 9 Price: Sw.fr. 8.-/US$ 6.40 The relationship between the mass media and alcohol control policy is the main subject of this literature review commissioned by WHO and undertaken by two researchers from the Social Research Institute of Alcohol Studies in Helsinki. The authors have comb- ed the most relevant studies of the last 18 years, the majority of them in North America or the Nordic countries, for information on four main themes: alco- hol advertising; alcohol education campaigns; the portrayal of alcohol, drinking and alcohol-related problems in the mass media; and the mass media as a forum for debate on alcohol control policy. Although alcohol advertising must be regarded mainly as an opposing force to controls, in practice the demarca- tion line is not so simple, as the alcohol industry itself has good reasons to promote moderation in drinking. Conversely, alcohol education cannot automatically be presumed to further the aims of control policies: done poorly, it may do more harm than good. This review will be of value to public health administrators and policy-makers, as well as to health promotion and health education professionals and anyone else concerned about the way our WHO Bulletin OMS. Vol. 68. 1990 525 Recent WHO publications attitudes and beliefs are influenced by the mass media. It concludes that while advertising is effective in promoting a positive image of alcohol (and should therefore be controlled), the media are less successful as a forum for discussion of alcohol policy and as a tool of education campaigns. Alcohol-related problems In high-risk groups Report on a WHO Study edited by M. Plant Copenhagen, WHO Regional Office for Europe, 1989, viii+114 pages (EURO Reports and Studies, No. 109). ISBN 92 890 1275 7 Price: Sw.fr. 11.-/US$ 8.80 Alcohol is by far the most widely used psychoactive drug in the world. At a time when international concern about illegal drug use is-rightly-at a high level, it is important to reassert the fact that the adverse consequences of alcohol misuse are far more widespread than those associated with the opiates and other illegal substances. This volume is the result of cooperation between the WHO Regional Office for Europe and researchers from seven European coun- tries. Its purpose is to discuss a number of practical issues related to the conduct of alcohol research, to indicate certain recent trends in alcohol use and misuse, and to highlight problems and priorities for research and policy. Alcohol misuse is now firmly established as a huge international problem. It is hoped that this review will help emphasize the value of epidemiological studies, as a means both of moni- toring the scale and pattern of such misuse and of identifying the most fruitful ways of responding to it. Urban development, housing Spotlight on the cities Improving urban health In developing countries I. Tabibzadeh, A. Rossi-Espagnet, & R. Maxwell Geneva, 1989, v+174 pages ISBN 92 4 156131 9 Price: Sw.fr. 30.-/US$ 24.00 This book challenges governments and health plan- ners to address the needs of the poor living in the shanty towns and slums of the developing world. Noting that the year 2000 will see an estimated one billion people living in urban squalor, the book calls for a radical reorientation of health priorities as the only way to deal with this growing urban crisis. Throughout the book, numerous case studies from around the world are used to illustrate both the magnitude of the problem and the options available for immediate action. Vector biology and control Geographical distribution of arthropod-borne diseases and their principal vectors Geneva, 1989, 134 pages (document WHO/VBC/89.967 issued by the WHO Division of Vector Biology and Control) Price: Sw.fr. 23.-/US$ 18.40 This manual draws together a wealth of information concerning the geographical importance and charac- teristics of 28 diseases transmitted by mosquitos, ticks, mites, lice, tsetse flies, kissing bugs, phlebotomine sandflies, fleas, blackflies and deer flies. The geographical distribution of both the diseases and the vectors responsible for their transmission is profiled in over 100 maps accompanied by concise explanatory texts. The manual is organized according to diseases, moving from malaria and mosquito- borne virus diseases, through the leishmaniases and trypanosomiases, to tick-borne and other diseases. Explanatory texts provide a concise factual overview of the history and evolution of the disease, epidemio- logical zones and their ecological features, character- istics of different vectors and vector-host cycles, and appropriate tactics for vector control. Information on clinical manifestations, treatments, and the numbers infected or at risk is also included in order to convey the magnitude of the public health problem posed by the disease. This document is intended to serve as a resource text for epidemiologists, health planners, and medical entomologists as well as a tool for training at middle and advanced levels. WHO Bulletin OMS. Vol. 68. 1990M2 Publications r6centes OMS Education, formation Guide pour la formation en nutrition des agents de sant6 communautaires Deuxieme edition Geneve, 1990, vii+ 127 pages ISBN 92 4 254210 5 Prix: Fr.s. 16.- Manuel oriente sur les taches pour la formation en nutrition des agents de sante communautaires; les informations et les instructions y sont presentees en deux parties. La premiere commence par une intro- duction aux objectifs et a l'utilisation du guide, puis precise quelles sont les competences requises pour rendre l'enseignant plus performant et enumere les elements fondamentaux de nutrition qui doivent etre inculques 'a l'agent de sante. La seconde partie reproduit neuf modules de formation. Chacun de ces modules est axe sur un sujet particulier et comprend des informations sur les taches qui s'y rapportent, les objectifs pedagogiques, le contenu de la formation de base et les methodes d'enseignement les mieux adap- tees au module en question. A la fin de chaque module, on trouvera des exercices pratiques a faire faire a titre d'entrainement ou pour evaluer la fagon dont les techniques sont maitrisees par les etudiants. Les auxiliaires pedagogiques et les methodes d'en- seignement sont presentes sous forme de tableaux qui font ressortir leurs avantages, leurs limites et leurs applications specifiques. Cette deuxieme edition du guide a ete revisee, etoffee en tenant compte de l'experience acquise sur le terrain. La presentation sous forme de modules facilite son adaptation aux besoins nutritionnels locaux et fait de ce manuel un instrument de formation et de reference particu- lierement utile pour les agents de sante communau- taires et le personnel charge de les encadrer ou de les former. L'6ducatlon pour la sant6 Manuel d'Aducation pour Ia sant6 dans l'optique des soins de santA primaires Gen6ve, 1990, xiii+261 pages ISBN 92 4 254225 3 Prix: Fr.s. 34.- Ce manuel s'adresse aux agents de sante qui doivent posseder les connaissances et capacites necessaires pour apprendre aux individus et aux communautes les moyens d'ameliorer leur propre sante. Reconnais- sant le role cle du comportement individuel pour la sante, le manuel vise a doter ses lecteurs d'une gamme de competences en matiere d'education et de communication qui respectent l'aspect humain et social de la sante et de la maladie, qui integrent les principes de l'auto-assistance et de l'auto-responsabi- lite et qui peuvent etre adaptees aux ressources et aux besoins locaux. I1 donne des explications et des conseils pratiques, completes par de nombreux exem- ples, des etudes de cas, des histoires, des exercices, des listes de controle et des illustrations qui aident le lecteur a comprendre l'application des principes dans la realite. Publie apres pres de huit annees d'essai sur le terrain et de revision, ce manuel constitue lui- meme une experience en matiere d'education pour la sante. Environnement L'utilisatlon des eaux us6es en agriculture et en aquiculture: recommandations A vls6es sanitaires Rapport d'un Groupe scientifique de l'OMS Gen6ve, 1989, 82 pages (OMS, S6rie de Rapports techniques, No 778). ISBN 92 4 220778 0 Prix: Fr.s. 9.- Ce rapport publie les nouvelles directives techniques et pratiques en matiere d'utilisation des eaux usees dans l'agriculture, l'arrosage des espaces verts et l'aquiculture, conformement aux mesures de protec- tion de l'environnement et aux mesures de lutte contre la transmission des maladies. Presentant les conclusions et recommandations d'un groupe inter- national d'experts, ce livre propose une formule d'utilisation des eaux usees qui est a la fois moins restrictive que les recommandations anterieures, et plus realiste quant aux risques averes pour la sante. Tout au long de l'ouvrage, un effort est fait pour fournir aux administrateurs des services hydrauliques les elements d'appreciation, les indicateurs de qualite et les conseils techniques dont ils ont besoin pour tirer parti de cette ressource precieuse sans mettre en danger la sante publique. Etant donne l'interet accru que l'on porte a l'utilisation des eaux usees, ce livre devrait encourager la planification et la conception de projets qui soient realisables sur le plan tech- nologique et economique, tout en etant capables de proteger la sante des ouvriers agricoles et des con- sommateurs. WHO Bulletin OMS. Vol. 68. 1990 527 Publications r6centes OMS Maladies transmissibles Contr6le continu des programmes natlonaux de lutte contre le SIDA Principes directeurs Gen6ve, 1990, iii+29 pages (Serie OMS SIDA 4). ISBN 9242210048 Prix: Fr.s. 8.- Cette nouvelle publication de la Serie OMS SIDA presente de fagon concise des directives pratiques devant aider les pays a se doter d'un systeme efficace et rationnel pour suivre et consigner les progres realises dans la mise en oeuvre d'un programme de lutte contre le SIDA. Redige a l'intention des admi- nistrateurs du systeme de sante, le livre dresse un cadre de mesures necessaires pour surveiller atten- tivement le deroulement des activites, les mouve- ments et l'utilisation du personnel, les etats des four- nitures et du materiel, et les sommes depensees par rapport aux ressources disponibles. Les informations fournies sont particulieres a la surveillance des strategies, cibles et activites fixees pour un plan 'a moyen terme couvrant une periode de 3 a 5 ans. Du debut a la fin, I'attention du lecteur est appelee sur la complexite d'un programme de lutte contre le SIDA et sur les competences gestionnaires speciales que necessite sa mise en ceuvre. Pr6parations pharmaceutiques, prodults biologiques La situation pharmaceutique dans le monde Geneve, 1990, vi + 135 pages ISBN 9242561142 Prix: Fr.s. 20.- Analyse de nombreux facteurs qui ont une incidence sur l'offre et la consommation actuelles de produits pharmaceutiques dans le monde. Le rapport, qui repose sur des donnees et des statistiques en pro- venance de plus d'une centaine de pays industrialises et en developpement, s'interesse surtout aux facteurs permettant d'evaluer la mesure dans laquelle les medicaments remplissent un role efficace dans la societe et les soins de sante. Cette enquete unique sur la situation pharmaceutique dans le monde analyse la situation et les tendances a la sous-prescription ou a la surprescription dans le secteur public, et le secteur prive, aux niveaux national et mondial. WHO Bulletin OMS. Vol. 68, 1990528