Recent WHO publications

RecentWHO publications/Publications recentes OMS Readers living in developing countries receive a 30% reduction on the prices indicated in Swiss francs. Les lecteurs residant dans les pays en d6veloppement b6n6ficient d'un rabais de 30% sur les tarifs indiqu6s en francs suisses. Chemical toxicology, carcinogenicity Deltamethrin a Geneva, 1990, 133 pages (Environmental Health Criteria, No. 97). ISBN 92 4 154297 7 Price: Sw.fr. 1 6.-/US$ 14.40 This book evaluates the risks to human health and the environment posed by the use of deltamethrin, a synthetic pyrethroid insecticide mainly used against agricultural pests. Marketed since 1977, deltame- thrin is most commonly used on cotton, fruit and vegetable crops, cereals, corn, and soybean. Delta- methrin is also used for the post-harvest protection of stored cereals, grains, coffee beans, and dry beans. Major public health applications include use in the control of Chagas disease in South America and in malaria control in Central America and on the African continent. The most extensive section examines the design and findings of numerous investigations of the effects of deltamethrin using experimental animals and in vitro test systems. The review found no evidence of mutagenic, teratogenic or reproductive effects, though it did cite evidence that the combined use of deltamethrin with some organophosphorus compounds can potentiate tox- icity. The final section evaluates effects on humans as observed following poisoning in cases of attemp- ted suicide, occupational accidents, and both short- and long-term occupational exposure. On the basis of this evaluation, the book concludes that exposure of the general population to deltamethrin is very low and that, provided recommended rates of applica- tion are followed, use of this insecticide is unlikely to present a hazard to either occupationally-exposed workers or the environment.b a 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). b A summary, conclusions, evaluation, and recommendations in French and Spanish are included in the book. Cyhalothrin a Geneva, 1990, 106 pages (Environmental Health Criteria, No. 99). ISBN 92 4 154299 3 Price: Sw.fr. 1 4.-/US$ 12.60 Cyhalothrin, a synthetic pyrethroid insecticide with a high level of activity against a wide range of agricultural pests, is also used in public health and animal health, where it effectively controls a broad spectrum of insects, including cockroaches, flies, mosquitos, and ticks. The most extensive section of the book reviews a large number of toxicological investigations using experimental animals and in vitro test systems. The review uncovered no evi- dence of carcinogenicity, mutagenicity, or disturbed reproductive functions, and no evidence of adverse effects on any aspect of fetal development at any of the experimental doses used. The final section, devoted to effects on humans, considers the clinical significance of a subjective facial sensation reported in laboratory workers, workers in manufacturing plants, and field operators handling cyhalothrin. While noting the documented occurrence of this syndrome, the report concludes that it is a transient phenomenon, that symptoms are not associated with objective physical signs, and that recovery is comple- te. On the basis of these evaluations, the report concludes that, when recommended safety precau- tions and rates of application are followed, cy- halothrin is highly unlikely to pose a risk to the environment, the general public, or occupationally- exposed workers. b Beryllium a Geneva, 1990, 210 pages (Environmental Health Criteria, No. 106). ISBN 92 4 157106 3 Price: Sw.fr. 23.-/US$ 20.70 Beryllium is a brittle metal with several unique properties. It is lighter than aluminium and more rigid than steel. When used as an additive in alloys, Bulletin of the World Health Organization, 69(4): 499-507 (1991) 499 Recent WHO publications it confers a combination of outstanding properties on other metals, including resistance to corrosion, high modulus of elasticity, non-magnetic and non- sparking characteristics, and increased electrical and thermal conductivities. These properties have led to major applications in the electronics and micro-elec- tronics industries, in nuclear energy, and in the production of military devices, including satellites, missiles, atomic bombs, and other weapons. Beryl- lium has also proved its superiority as a structural material for aircraft and spacecraft, where a combi- nation of light weight, rigidity, dimensional stability, and good thermal characteristics is demanded. An extensive section of the book evaluates data from the larger number of toxicological studies conducted in experimental animals and in vitro test systems. Key findings include the development of acute chemical pneumonitis in several species ex- posed via the inhalation route and a highly species- specific induction of pulmonary cancer. An evalu- ation of effects on humans, which concentrates on occupational exposures, summarizes the large num- ber of studies documenting the occurrence of both acute and chronic beryllium diseases. In view of the controversy concerning the carcinogenicity of beryl- lium, particularly careful attention was given to several studies reporting a significantly elevated risk of lung cancer in exposed workers. Evidence was judged sufficient to confirm the role of beryllium in the development of human lung cancer. The report further concludes that the potential of beryllium to provoke contact allergic reactions, supported by several reports of allergic contact stomatitis in dental patients, calls for a reconsideration of the use of this metal in dentistry. c Tricresyl phosphatea Geneva, 1990, 122 pages (Environmental Health Criteria, No. 110). ISBN 92 4 157110 1 Price: Sw.fr. 15.-/US$ 13.50 This report evaluates the risks to human health and the environment posed by the production and use of this compound, which is used in industry as a plasticizer in vinyl plastic manufacture, as a flame- retardant, as a solvent for nitrocellulose, in cellu- losic molding compositions, and in the manufacture of fire-resistant hydraulic fluids and lubricants. The book summarizes the chemical properties and methods of analysis for tricresyl phosphate and c A summary and conclusions in French and Spanish are included in the book. its isomers, outlines the most important sources of human and environmental exposure, assesses the findings from investigations of levels found in workplace air, drinking-water, sediment, soil, and vegetation, and evaluates the effects on organisms in the environment. Because of its physicochemical properties and rapid biodegradation, the report concludes that use of this compound does not threaten the environment, though there is some evidence that crop plants can be affected by tri-o- cresyl phosphate released from plastic coverings. A section on kinetics and metabolism concentrates on mechanisms of absorption, distribution, metabolic transformation, and excretion that can help explain the well-documented neuropathic effects of tricresyl phosphate and, most notably, its highly toxic isomer, tri-o-cresyl phosphate. These effects are further characterized through a review of the numer- ous reported cases of large-scale human poisoning following the ingestion of accidentally or deliber- ately contaminated medicines, food, flour, cooking oil, and beverages. Detailed information is given on the clinical symptoms of poisoning, the characteris- tics of delayed neuropathy, long-term prognosis, and advice on the first-aid treatment of victims. Although tricresyl phosphate poses very little risk to the environment and the general population, the report underscores the severity and long-duration of the neuropathology caused by accidental poisoning, noting that some victims never recover. d Triphenyl phosphatea Geneva, 1991, 80 pages (Environmental Health Criteria, No. 1 11). ISBN 92 4 157111 X Price: Sw.fr. 11.-/US$ 9.90 Triphenyl phosphate (TPP) is a compound widely used as a flame retardant in phenolic and phenylene- oxide-based resins for the manufacture of electrical and automobile components, as a non-flammable plasticizer in cellulose acetate for photographic films, and as a component of hydraulic fluids and lubricant oils. A review of data on the effects of TPP in the aquatic environment concludes that it is the most acutely toxic of the various triaryl phosphates to fish, shrimps, and daphnids. No data on toxicity to terrestrial organisms other than fungi are at present available. While noting that the toxicity profile is inadequate to allow a full evaluation of risks to dA summary, evaluation, and recommendations in French and Spanish are included in the book. 500 WHO Bulletin OMS. Vol 691991. Recent WHO publications human health, the report concludes that exposure of both the general population and workers is low. d Tri-n-butyl phosphatea Geneva, 1991, 80 pages (Environmental Health Criteria, No. 112). ISBN 92 4 157112 8 Price: Sw.fr. 11 .-/US$ 9.90 Tri-n-butyl phosphate (TBP) is widely used as a solvent for cellulose esters, lacquers, and natural gums, as a primary plasticizer in the manufacture of plastics and vinyl resins, in the formulation of fire-resistant aircraft hydraulic fluids, and as an antifoaming agent, mainly in paper manufacturing plants. Although TBP has been detected in air, water, sediment, and biological tissues, the review notes that concentrations are usually very low. Routes of exposure for workers and for the general population are discussed and effects on organisms in the environment considered. Workers involved in aircraft maintenance and exposed during the ma- nipulation of hydraulic fluids are regarded as the largest occupational group at risk. The report was unable to reach firm conclusions concerning the risks posed by TBP as a potential carcinogen, neurotoxic agent, or dermal sensitizer, though a neurotoxic effect comparable to organo- phosphate-induced delayed neuropathy was judged unlikely. The evaluation of data on risks to humans is largely confined to reports of headache, nausea, and irritation of the skin, eye, and mucous mem- brane. The report concludes that the production and use of TBP pose a low risk for the environment and for the general population, and that the likelihood of long-term effects in occupationally exposed workers is small. d Tributyltin compoundsa Geneva, 1990, 273 pages (Environmental Health Criteria, No. 116). ISBN 92 4 157116 0 Price: Sw.fr. 29.-/US$ 26.10 Tributyltin (TBT) compounds are used as mollusci- cides, as antifoulants on boats, ships, quays, buoys, and equipment in the fishing industry, as wood preservatives, and as slimicides on masonry. They are also used as biocides for cooling systems, power station cooling towers, pulp and paper mills, textile mills, and breweries. These compounds pose a particular threat to the marine environment in view of their documented high toxicity to aquatic organ- isms, including commercially important shellfish. These toxic effects are thoroughly evaluated in separate chapters dealing with algae and other microorganisms, aquatic organisms, and terrestrial organisms. TBT compounds are observed to be toxic to microorganisms and highly toxic to oysters, mussels, and other marine molluscs consumed by humans. The book concludes that TBT compounds are a severe irritant to human skin and an extreme irritant to the eye, and that inhalation of aerosols can have especially hazardous effects on the res- piratory tract. Despite the large body of experi- mental studies documenting toxicity, the book was unable to quantify the risk to humans posed by the consumption of contaminated fish and shellfish. d Methyl isobutyl ketonea Geneva, 1990, 79 pages (Environmental Health Criteria, No. 1 17). ISBN 92 4 157117 9 Price: Sw.fr. 11 .-/US$ 9.90 This book evaluates the risks to human health and the environment posed by the widespread produc- tion and use of methyl isobutyl ketone (MIBK) as a solvent, with major applications in the production of lacquers and paint solvents, including car and industrial spray paints. MIBK also occurs naturally in food, is a permitted flavouring agent, and is used in food contact packaging materials. The most extensive section reviews findings from a large number of studies conducted in experimental ani- mals and in vitro test systems, designed to test the toxicity of this chemical and its actions as a skin and respiratory tract irritant, its effects on reproduction, and its embryotoxicity, teratogenicity, carcinogen- icity, and mutagenicity. A review of studies con- ducted in human volunteers and in occupationally- exposed workers concludes that exposure to MIBK can cause eye and respiratory irritation as well as symptoms of headache, nausea, and vertigo. The review found no evidence that exposure to this chemical causes permanent damage to the nervous system of workers or that its presence in the environment and in food poses any threat to the general population. d Pharmaceutical drugs Lyon, International Agency for Research on Cancer, 1990, 415 pages (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 50). ISBN 92 832 1250 9 Price: Sw.fr. 65.-/US$ 58.50 WHO Bulletin OMS. Vol 69 1991. 501 Recent WHO publications This is the report of a working group convened to evaluate the carcinogenic risk to humans posed by the therapeutic use of 15 pharmaceutical drugs: five antineoplastic agents, four antimicrobial agents, two diuretics, ciclosporin (an immunosuppressant), ci- metidine (used in the treatment of gastric and duodenal ulcers), paracetamol (a popular analgesic and antipyretic drug), and dantron (a laxative). Their selection was on the basis of published data suggesting carcinogenic effects in experimental ani- mals or in human patients treated with the drug. Conclusions concerning the carcinogenic potential of each drug are formulated following a critical review of all published data, including findings from assays for genetic and related effects, relevant to the assessment of carcinogenicity in humans. The ex- perts noted that inference of carcinogenic hazard was likely to be a major factor in regulatory decisions regarding the continued usage of many of the drugs considered, though the need to balance potential carcinogenicity with an assessment of therapeutic benefits was regarded as essential. Coffee, tea, mate, methylxanthines and methylglyoxal Lyon, International Agency for Research on Cancer, 1991, 513 pages (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 51). ISBN 92 832 1251 7 Price: Sw.fr. 80.-/US$ 72.- This book is the report of a working group convened to evaluate the strength of evidence linking the drinking of coffee, tea, and mate to the development of human cancer. Separate evaluations are also provided for caffeine, theophylline, theobromine and methylglyoxal, which are chemical constituents of coffee, tea, and several other popular beverages. Although emphasis is placed on evidence of car- cinogenic risks, the book also considers possible effects on human reproduction and fetal develop- ment. The first monograph evaluates the large number of studies designed to assess the carcino- genic potential of coffee. On the basis of available data, the working group concluded that coffee is possibly carcinogenic to the human urinary bladder. Evidence further suggests that coffee may actually protect humans against cancer of the colon and rectum. The risk for breast cancer was shown, with remarkable consistency, to have no association with coffee drinking. The second monograph evaluates the carcinogenicity of black and green teas. Al- though available data were judged inadequate to classify tea according to its carcinogenic risk, the analysis uncovered evidence suggesting that the temperature at which tea is drunk may be a more important determinant of risk than the chemical composition of the beverage. This observation is further supported in the monograph on mate, a South American beverage which is usually drunk very hot following repeated addition of almost boiling water to the infusion. While mate could not be classified on the basis of available data, hot mate drinking was judged to have a probable association with the development of oesophageal and oral cancers. Each of the remaining monographs on caffeine, theophylline, theobromine, and methyl- glyoxal determined that evidence was inadequate for an assessment of carcinogenic effects. Environmental engineering Surface water drainage for low-income communities Published by WHO in collaboration with the United Nations Environment Programme Geneva, 1991, v + 88 pages ISBN 92 4 154416 3 Price: Sw.fr. 16.-/US$ 14.40 This book provides a detailed practical and technical guide to the design, construction, rehabilitation, and maintenance of surface water drainage systems in low-income urban areas. Noting that drainage often figures first on the list of felt needs among the residents of such areas, the book concentrates on the many "do-it-yourself" measures that communities can undertake to construct a simple, effective, low-cost drainage system or to rehabilitate an existing system that has fallen into disrepair. Proj- ects conducted with engineering assistance and municipal support are also thoroughly described, emphasizing the importance of community involve- ment in such projects at every stage. Written in nontechnical language and copiously illustrated with drawings and photographs, the book will be a valuable resource for local authorities and commu- nity groups, as well as engineering consultants, planners, and public works officials in developing countries. Epidemiology, statistics World health statistics annual 1990 Geneva, 1991, xxiv + 423 pages ISBN 92 4 067905 7 Price: Sw.fr. 90.-/US$ 81.- WHO Bulletin OMS. Vol 69 1991.502 Recent WHO publications The World health statistics annual presents global statistical information designed to provide both country 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. The 1990 edition opens with a detailed analysis of global data on a selection of special topics. Those covered include an epidemiological assessment of the status of malaria for 1988, the prevalence of blindness worldwide, per capita consumption of pharmaceutical products for 1989, the steady rise in global immunization coverage rates between 1985 and 1988, causes of death in 1985 in developed and developing countries, urbanization trends and pro- jections for the period 1970-2000, and the leading causes of premature mortality in developed coun- tries at ages 15-64 years. The second section reviews national disability statistics available for monitoring the causes of disability as reported in population censuses, household surveys and administrative reg- istries. These statistics are based on national statis- tics which have been compiled in the United Nations Disability Statistics Data Base of 55 countries. Tables in the third section summarize the demo- graphic situation of countries in terms of those parameters likely to be of greatest relevance for health management. The final and most extensive section consists of a series of tabular statistics on causes of death, by sex and by age. Sample size determination in health studies A practical manual S.K. Lwanga & S. Lemeshow Geneva, 1991, viii + 80 pages ISBN 92 4 154405 8 Price: Sw.fr. 1 6.-/US$ 14.40 This manual presents the practical and statistical information needed to help investigators decide how large a sample to select from a population targeted for a health study or survey. Designed to perform a "cookbook" function, the book uses explanatory text and abundant tabular calculations to vastly simplify the task of determining the minimum sample size needed to obtain statistically valid results. The objective is to assist those investigators, undertaking health studies at local or district level, who lack detailed knowledge of statistical method- ology. Food safety Public health impact of pesticides used in agriculture Published by WHO in collaboration with the United Nations Environment Programme Geneva, 1990, 128 pages ISBN 92 4 156139 4 Price: Sw.fr. 21.-/US$ 18.90 Drawing upon data collected by WHO and the United Nations Environment Programme, the book aims to provide a framework for understanding the magnitude of pesticide-associated health problems, identifying groups at special risk, knowing which compounds pose special problems, and finding safer alternatives. Throughout, emphasis is placed on the need to balance alarm about the hazards of pesti- cides with a sound understanding of precise risks and the best ways to prevent them. Although the book takes a global approach, particular attention is given to the special problems of pesticide safety in developing countries. Pharmaceuticals WHO model prescribing information: drugs used in parasitic diseases Geneva, 1990, 126 pages ISBN 92 4 140102 8 Price: Sw.fr. 21.-/US$ 18.90 This book provides model prescribing information for a large number of essential drugs used for the prevention and treatment of protozoal and helmin- thic infections, including filarial infections, the leish- maniases, malaria, schistosomiasis and the trypano- somiases. The book is the product of a consultative process involving internationally accredited experts, all members of WHO's expert advisory panel on drug evaluation, selected members of the various WHO expert advisory panels on parasitic diseases, and certain nongovernmental organizations in offi- cial relations with WHO. The book is organized according to diseases, moving from amoebiasis and giardiasis to miscella- neous intestinal infections. Each disease or group of diseases is first introduced with concise information about its causes, mode of transmission, clinical features, and geographical prevalence, followed by general advice on prevention and treatment. Pre- scribing information is then provided for first-choice and alternative therapeutic and prophylactic drugs. Information includes uses, dosage and administra- tion, contraindications and precautions, use in preg- nancy, adverse effects, drug interactions, and advice WHO Bulletin OMS. Vol 69 1991. 503 Recent WHO publications/Publications r6centes OMS on storage. This volume is part of a series intended to provide up-to-date and independent clinical information on essential drugs. The objec- tive is to give national authorities, particularly in developing countries, authoritative and reliable in- formation that can guide the development of na- tional drug formularies, drug compendia and similar material. e Surgery, anaesthesia Surgery at the district hospital: obstetrics, gynaecology, orthopaedics, and traumatology edited by J. Cook, B. Sankaran, & A.E.O. Wasunna illustrated by D. Atherton, E. Sacco, & P. Virolle Geneva, 1991, 207 pages ISBN 92 4 154413 9 Price: Sw.fr. 25.-/US$ 22.50 In 24 chapters, this book provides an illustrated guide to a limited number of essential surgical procedures for treating the major complications of pregnancy and childbirth and for managing trau- matic injuries, including fractures and burns. Gynae- cological procedures commonly required in small hospitals are also covered. Throughout the book, emphasis is placed on standard surgical protocols that represent the safest line of action in hospital settings where equipment may be primitive, drugs limited, and specialist services sparse. This hand- book completes a series of three volumesf designed to extend the competence of the general duty doctor who works in a small hospital, is called upon to treat a range of conditions and emergencies, and yet is Abus de substances L'abus des drogues. Prevention et lutte Publie sous la direction de M. Gossop & M. Grant Genbve, 1991, ix + 141 pages ISBN 92 4 256134 7 Prix: Fr.s. 24.- e See WHO model prescribing information: drugs used in anaes- thesia. Geneva, WHO, 1989, reviewed in the Bulletin of the World Health Organization, 68(1): 134 (1990). ' See: Dobson, M.B. Anaesthesia at the district hospital. Geneva, World Health Organization, 1988, and Cook, J. et al. General surgery at the district hospital. Geneva, World Health Organization, 1988. constrained by limited training, equipment and drugs. Procedures were selected for inclusion on the basis of their capacity to save lives, alleviate pain, prevent the development of serious complications, or stabilize a patient's condition pending referral. In producing these manuals, WHO aims to help doc- tors acquire a repertoire of standard, vital tech- niques that are simple and safe, yet in line with the highest level of scientific knowledge. Traditional medicine A proposed standard international acupuncture nomenclature Report of a WHO Scientific Group Geneva, 1991, vi + 30 pages ISBN 92 4 154417 1 Price: Sw.fr. 9.-/US$ 8.10 This book records the consensus reached by a group of 12 experts commissioned to develop a standard international nomenclature for identifying the me- ridians, points, and lines used in acupuncture. The nomenclature, which has been under development since 1981, is intended to facilitate communication among those engaged in both the practice of acupuncture and research into its modes of action and therapeutic efficacy. Classical acupuncture points, in use for more than 2500 years, are covered together with several new points introduced over the past two decades. The book concludes with a series of recommendations for the standardization of other areas of acupuncture nomenclature and for further action pertaining to training for the practice of acupuncture, regulation by health authorities, safety, and research. 9 On trouvera exposes dans ce livre un certain nombre de concepts, de modeles et d'approches qui permet- tront peut-etre au lecteur de mieux saisir la com- plexite du probleme de l'abus des drogues, d'etablir des objectifs realistes de prevention et de lutte et d'adopter les strategies qui ont le plus de chances de reussir. S'appuyant sur les resultats de recherches et les experiences menees dans differents pays, l'ouvra- ge met en garde contre les explications et les 9 A memorandum based on this report was published in the Bulletin of the World Health Organization, 68(2): 165-169 (1990). The French version of the memorandum appeared in the Bulletin of the World Health Organization, 68(4): 425-429 (1 990). 504 WHO Bulletin OMS. Vol 69 1991. Publications r6centes OMS solutions universelles, estimant que, pour etre effi- caces, les strategies doivent etre fondees sur une bonne connaissance des differentes formes d'abus des drogues et de la diversite des consommateurs qui ont besoin d'etre aides. Il est l'aboutissement de plusieurs annees de travail de l'OMS. Il tient compte egalement des debats qui ont eu lieu lors de la Conference des ministres de la sante sur l'abus des stupefiants et des substances psychotropes organis6e conjointement par l'OMS et le Gouvernement du Royaume-Uni a Londres en 1986. L'alcool et les m6dias J. Partanen & M. Montonen Copenhague, Bureau r6gional de l'Europe, 1990, 94 pages (Rapports et Etudes EURO, No 108). ISBN 92 890 2274 4 Prix: Fr.s. 8.- A la demande de l'OMS, deux chercheurs de l'Institut de recherche sociale sur l'alcoolisme d'Hel- sinki ont passe en revue les ouvrages abordant explicitement la question des liens entre les medias et les politiques de lutte contre l'alcoolisme. Les auteurs ont passe au crible les etudes les plus pertinentes de ces quelque 18 dernieres annees, la plupart d'entre elles realisees en Amerique du Nord ou dans les pays nordiques, pour recueillir des informations sur les quatre points suivants: la publicite pour l'alcool; les campagnes d'information sur l'alcool; la maniere dont l'alcool, I'alcoolisation et les problemes lies a l'alcool sont representes dans les medias; et les medias en tant que lieu permettant de debattre publiquement des politiques de lutte contre l'alcoolisme. Bien que la publicite pour l'alcool doive etre essentiellement consideree com- me une force d'opposition a la lutte anti-alcoolique, dans la pratique les choses ne sont pas toujours aussi evidentes dans la mesure oiu l'industrie des boissons alcooliques elle-meme a de bonnes raisons de promouvoir la moderation. A l'inverse, les efforts d'6ducation deployes pour sensibiliser le public aux dangers de l'alcool ne vont pas automatiquement dans le sens des campagnes contre l'alcoolisme: des mesures mal con,ues peuvent faire plus de mal que de bien. Cet ouvrage sera precieux pour les administra- teurs des programmes de sante publique et les decideurs ainsi que pour les professionnels charges de la promotion de la sante et de l'education pour la sante, et pour ceux qui s'interrogent sur la maniere dont les medias influencent nos attitudes et nos croyances. Les auteurs concluent que si la publicite reussit a donner une image positive de l'alcool (d'oui la necessite de la controler), les medias parviennent difficilement a etre une tribune permettant de debattre les politiques de lutte contre l'alcoolisme et un instrument pour les campagnes d'education. Les problemes lies a la consommation d'alcool dans les groupes a haut risque Rapport sur une Etude de I'OMS Textes pr6sent6s par M. Plant Copenhague, Bureau regional de l'Europe, 1990, viii + 128 pages (Rapports et Etudes EURO, No. 109). ISBN 92 890 2275 2 Prix: Fr.s. 1 1.- L'alcool est de loin la substance psychotrope la plus utilisee dans le monde. A un moment oiu la commu- naute internationale se montre-a juste titre- vivement preoccupee par l'usage illicite des drogues, il n'est pas inutile de rappeler que les effets nefastes de l'abus d'alcool sont beaucoup plus repandus que ceux qui sont associes aux opiaces et autres substan- ces illicites. Ce volume est le resultat d'un travail de cooperation entre le Bureau regional de l'OMS pour l'Europe et des chercheurs de sept pays d'Europe. II aborde un certain nombre de questions concretes liees a la conduite de la recherche en alcoologie, indique certaines tendances recentes de la consom- mation et de l'abus d'alcool, et met en relief les problemes et les priorites de la recherche et de l'action gouvernementale. L'abus d'alcool est main- tenant reconnu comme un probleme inter- national majeur. Souhaitons que cette etude contribue 'a mettre en lumiere l'interet des etudes epidemiologiques comme moyen de suivre l'ampleur et les modalites de ce phenomene et de trouver comment y faire face le plus efficacement possible. Education, formation Alimentation, environnement et sante Le livre du maltre d'ecole T. Williams, A. Moon & M. Williams Geneve, 1990, xix + 133 pages ISBN 92 4 254400 0 Prix: Fr.s. 26.- Ce livre offre a l'educateur tout un ensemble de faits, de conseils, de projets, de jeux, d'illustrations, d'anecdotes et de questions types extremement pratiques pour enseigner aux enfants l'importance des habitudes d'hygiene, s'agissant en particulier des aliments, du corps et de l'environnement domesti- que. On y trouve des conseils sur la fa,on de creer WHO Bulletin OMS. Vol 69 1991. 505 Publications r6centes OMS un potager, ou encore les regles d'un jeu de la "guerre des microbes" qui illustre la fagon dont les agents pathogenes envahissent le corps humain, en passant par l'elaboration d'un diagramme de crois- sance de la classe. Tout au long, simplicite et imagination caracterisent les moyens proposes pour corriger les erreurs frdquemment commises dans les pays en developpement sur la securite des denrees alimentaires, la nutrition et l'hygiene personnelle. Epidemiologie, statistiques Annuaire de statistiques sanitaires mondia- les 1990 Geneve, 1991, xxiv + 423 pages ISBN 92 4 067905 7 Prix: Fr.s. 90.- L'Annuaire de statistiques sanitaires mondiales contient 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 change- ments qu'ils observent. L'edition 1990 debute par I'analyse detaillee de donnees mondiales sur une serie de sujets particu- liers. Parmi eux figurent l'evaluation epidemiolo- gique de la situation du paludisme en 1988, la prevalence de la cecite dans le monde, la consomma- tion de produits pharmaceutiques par habitant en 1989, l'augmentation reguliere des taux de couver- ture vaccinale mondiale entre 1985 et 1988, les causes de deces survenus en 1985 dans les pays developpes et en developpement, les tendances et projections en matiere d'urbanisation pour la perio- de 1970-2000, et les principales causes de mortalite prematuree chez les 15-64 ans dans les pays developpes. La deuxieme section examine les statis- tiques nationales utilisees pour surveiller les causes d'incapacites, qui sont publiees dans les recense- ments de la population, les enquetes sur les menages et les registres administratifs. Ces statistiques se fondent sur les statistiques nationales reunies dans la Banque de donnees statistiques des Nations Unies sur les incapacites dans 55 pays. Les tableaux de la troisieme section resument la situation demographi- que des pays en se basant sur les parametres qui peuvent presenter le plus d'int6ret pour les gestion- naires de la sante. La derniere section, qui est aussi la plus etendue, comporte une serie de tableaux statistiques sur les causes de deces par sexe et par age. Nutrition Prevenir et combattre I'anemie ferriprive dans le cadre des soins de sante primaires Guide a l'usage des administrateurs de la sant6 et des responsables de programme E.M. DeMayer avec la collaboration de P. Dallman, J.M. Gurney, L. Hallberg, S.K. Sood & S.G. Srikantia Geneve, 1991, 61 pages ISBN 92 4 254249 0 Prix: Fr.s. 11.- Cet ouvrage fait le point sur l'ensemble des aspects techniques et pratiques 'a prendre en consideration pour l'elaboration de strategies directes, efficaces et de faible cofut destinees 'a lutter contre l'andmie ferriprive. Notant que cette affection touche plus de 700 millions de personnes dans le monde, les auteurs se sont efforces de montrer comment les nouvelles connaissances sur les moyens techniques de preven- tion et de lutte pouvaient etre utilisdes pour attein- dre le plus grand nombre possible de personnes au moindre coiut. Tout au long de cette etude, l'accent est mis sur les problemes et les ecueils dont il faut tenir compte, notamment dans les pays en develop- pement, pour choisir les mesures de lutte les plus approprides. h Alimentation et sante La prevention des maladies d'origine alimentaire en Europe W.P.T. James en collaboration avec A. Ferro-Luzzi, B. Isaksson & W.B. Szostak Copenhague, Bureau regional de l'Europe, 1990, xiii + 161 pages (OMS, Publications r6gionales, S6rie europeenne, No 24). ISBN 92 890 2115 2 Prix: Fr.s. 20.- Expose stimulant de ce que les pouvoirs publics des pays europeens pourraient faire pour prevoir dans leurs politiques alimentaires des objectifs d'ordre sanitaire, etant donne les innombrables indices selon lesquels il existe un lien entre alimentation et h Voir egalement: Carence martiale et fonction cerebrale, Bulletin de lOrganisation mondiale de la Sante, 67(5): 592-594 (1989), et Supplementation en fer: pourquoi les femmes enceintes ne l'observent-elles pas?, Bulletin de l'Organisation mondiale de la Sante, 69(1): 134-135 (1991). 506 WHO Bulletin OMS. Vol 69 1991. Publications r6centes OMS maladie.' Ecrit par des medecins nutritionnistes, ce livre est tout a la fois une source abondante de renseignements sur les habitudes alimentaires des Europeens et un plaidoyer convaincant en faveur de mesures destinees 'a leur permettre de choisir une alimentation saine. Les auteurs font des recomman- dations concretes sans oublier un instant les difficul- tes que representent une modification des choix alimentaires traditionnels, une nouvelle orientation des politiques agricoles et l'amelioration des prati- ques de fabrication de l'industrie alimentaire. Readaptation Aider les personnes handicapees Ia ou elles vivent par E. Helander, P. Mendis, G. Nelson & A. Goerdt Geneve, 1991, 848 pages, 2000 illustrations ISBN 92 4 254401 9 Prix: Fr.s. 80.- Ce manuel comprend 4 guides et 30 modules d'entrainement. On trouvera dans les quatre guides les principes de base et les conseils importants pour l'agent communautaire charge du programme de readaptation communautaire, pour les handicapes, pour le comite de readaptation communautaire et les enseignants locaux. Les modules d'entrainement presentent des methodes de readaptation pour sept types de handicap: difficulte a voir, difficulte a entendre et a parler, difficulte' A se mouvoir, insensibilite de certains membres, comportement ' Voir a ce sujet I'analyse de fRgime alimentaire, nutrition et prevention des maladies chroniques. Rapport d'un Groupe d'Etude de l'OMS (S6rie de Rapports techniques, No 797, 1990), Bulletin de lOrganisation mondiale de la Sante, 69(2): 257-258 (1991). etrange, crises convulsives, et difficulte 'a apprendre. Afin de faciliter la traduction et l'adaptation du manuel, le langage a e't simplifie, le nombre de mots differents a ete limite a environ 1800. Du debut jusqu'a la fin, de nombreux dessins accompagnent les instructions simples qui aideront progressive- ment les handicapes 'a ameliorer eux-memes leur existence. Securite alimentaire L'utilisation des pesticides en agriculture et ses consequences pour la sante publique Publie par l'OMS en collaboration avec le Programme des Nations Unies pour I'Environnement Geneve, 1991, 145 pages ISBN 92 4 256139 8 Prix: Fr.s. 31.- S'appuyant sur un ensemble de donnees recueillies par l'OMS et par le Programme des Nations Unies pour l'Environnement, cet ouvrage a pour but de fournir un cadre pour la comprehension de I'ampleur des problemes de sante associes aux pesticides, pour l'identification des groupes speciale- ment 'a risque, pour la connaissance des composes ainsi que des problemes particuliers qu'ils posent, et pour la mise au point de nouvelles methodes plus sfires. Tout au long du livre, l'accent est mis sur la double necessite d'avertir du danger constitue par l'utilisation des pesticides, et neanmoins d'analyser sainement les risques exacts; on insiste egalement sur les me'thodes de prevention les plus appropriees de ces risques. Bien que l'on ait, dans ce livre, adopte une approche mondiale, une attention parti- culire est accordee aux problemes speciaux de securite des pesticides dans les pays en developpe- ment. WHO Bulletin OMS. Vol 69 1991. 507