Occupational and

Environmental MedicineAdopted as the Journal of the Faculty of

Occupational Medicine of the Royal College ofPhysicians ofLondon

Editor: Anne Cockcroft (United Kingdom)Technical Editor: Judith HaynesEditorialAssistant Rachel HarveyEditorial Board:T C Aw (United Kingdom) R McNamee (United Kingdom) M Singal (United States)F J H Van Dijk (Holland) J Myers (South Africa) D C Snashall (United Kingdom)J S Evans (United States) B Nemery (Belgium) 0 Svane (Denmark)R M Harrison (United Kingdom) T Okubo Japan) G Thriault (Canada)J Jeyaratnam (Singapore) P Paoletti (Italy) KM Venables (United Kingdom)F Kauffmann (France) L Rosenstock (United States) Editor, British MedicalJournalR L Maynard (United Kingdom) M Sim (Australia)

NOTICE TO CONTRIBUTORS Occupational and EnvironmentalMedicine is intended for the publication of original contribu-tions relevant to occupational and environmental medicine,including toxicological studies of chemicals of industrial, agri-cultural, and environmental importance, and epidemiologicalstudies. As well as full papers, short papers dealing with briefor preliminary observations relevant to occupational and envi-ronmental medicine will also be considered. Case reportsshould cover substantial new ground to merit publication.Other articles, including review or position papers, will be con-sidered but should not be submitted without first approachingthe Editor to discuss their suitability for the Journal. Letters tothe Editor are always welcome.INSTRUCTIONS TO AUTHORS Three copies of all submissionsshould be sent to: The Editor, Occupational and EnvironmentalMedicine, BMJ Publishing Group, BMA House, TavistockSquare, London WC1H 9JR, UK All authors should sign thecovering letter as evidence of consent to publication. Papersreporting results of studies on human subjects must be accom-panied by a statement that the subjects gave written, informedconsent and by evidence of approval from the appropriateethics committee. These papers should conform to theprinciples outlined in the Declaration of Helsinki (BMJl1964;ii:177).

If requested, authors shall produce the data on which themanuscript is based, for examination by the Editor.Authors are asked to submit with their manuscript the

names and addresses of three people who they considerwould be suitable independent reviewers. They will notnecessarily be approached to review the paper.

Papers are considered on the understanding that they aresubmitted solely to this Journal and do not duplicate materialalready published elsewhere. In cases of doubt, where part ofthe material has been published elsewhere, the publishedmaterial should be included with the submitted manuscript toallow the Editor to assess the degree of duplication. TheEditor cannot enter into correspondence about papers rejectedas being unsuitable for publication, and the Editor's decisionin these matters is final.Papers should include a structured abstract of not

more than 300 words, under headings of Objectives,Methods, Results, and Conclusions. Please include up tothree keywords or key terms to assist with indexing.

Papers should follow the requirements of the InternationalCommittee of Medical Journal Editors (BMJ 1991;302:338-41). Papers and references must be typewritten in doublespacing on one side of the paper only, with wide margins. SIunits should be used.

Short reports (including case reports) should be not morethan 1500 words and do not require an abstract. They shouldcomprise sections of Introduction, Methods, Results, andDiscussion with not more than one table or figure and up to10 references. The format of case reports should beIntroduction, Case report, and Discussion.Illustrations Photographs and photomicrographs on glossypaper should be submitted unmounted. Charts and graphsshould be carefully drawn in black ink on firm white paper.Legends to figures should be typed on a separate sheet ofpaper.References References will not be checked by the editorialoffice; responsibility for the accuracy and completeness of ref-erences lies with the authors. Number references consecutivelyin the order in which they are first mentioned in the text.Identify references in texts, tables, and legends by Arabicnumerals. References cited only in tables or in legends to fig-ures should be numbered in accordance with a sequence estab-

wished by the first identification in the text of a particular tableor illustration. Include only references essential to the argu-ment being developed in the paper or to the discussion ofresults, or to describe methods which are being used when theoriginal description is too long for inclusion. Information frommanuscripts not yet in press or personal communicationsshould be cited in the text, not as formal references.Use the Vancouver style, as in this issue for instance, for a

standard journal article: authors (list all authors when seven orfewer, when eight or more, list only six and add et al), title,abbreviated title of journal as given in Index Medicus (if notin Index Medicus give in full), year of publication, volumenumber, and first and last page numbers.Proofs Contributors will receive one proof. Only minor cor-rections can be made at this stage; corrections other thanprinter's errors may be charged to the author.

Reprints Reprints will be charged for. The number ofreprints required should be stated on the form provided withthe proofs.Copyright C 1995 Occupational and Environmental Medicin.This publication is copyright under the Berne Convention andthe International Copyright Convention. All rights reserved.Apart from any relaxations permitted under national copyrightlaws, no part of this publication may be reproduced, stored ina retrieval system, or transmitted in any form or by any meanswithout the prior permission of the copyright owners.Permission is not, however, required to copy abstracts ofpapers or of articles on condition that a full reference to thesource is shown. Multiple copying of the contents of the publi-cation without permission is always illegal.NOTICE TO ADVERTISERS Applications for advertisementspace and for rates should be addressed to the AdvertisementManager, Occupational and Environmental Medicine, BMUPublishing Group, BMA House, Tavistock Square, LondonWC1H 9JR.NOTICE TO SUBSCRIBERS Occupational and EnvironmentalMedicine is published monthly. The annual subscription rate(for 1995) is £139 (US $240). Orders should be sent to theSubscription Manager, Occupational and EnvironmentsMedicine, BMJ Publishing Group, BMA House, TavistockSquare, London WC1H 9JR Orders may also be placed withany leading subscription agent or bookseller. (For the conve-nience of readers in the USA subscription orders with or with-out payment may also be sent to Bnitish Medical Joul,4 POBox 408, Franklin, MA 02038, USA. All inquiries, however,must be addressed to the publisher in London). All inquiriesregarding air mail rates and single copies already publishedshould be addressed to the publisher in London.Subscribers may pay for their subscriptions by Access, Visa, orAmerican Express by quoting on their order the credit orcharge card preferred together with the appropriate personalaccount number and the expiry date of the card.Second class postage paid Rahway NJ. Postmaster: sendaddress changes to: Occupational and Environmental Medicine,c/o Mercury Airfreight International Ltd Inc, 2323 RandolphAvenue, Avenel, NJ 07001, USA.FACULTY OF OCCUPATIONAL MEDICINE The Faculty ofOccupational Medicine of the Royal College of Physicians ofLondon is a registered charity founded to promote, for thepublic benefit, the advancement of knowledge in the field ofoccupational medicine. The Faculty has offices at 6 StAndrew's Place, Regent's Park, London NW1 4LB.

ISSN 1351-0711.

Published by BMJPublishing Group andprinted in England byEyre & Spottiswoode Ltd,London and Margate

ME

Cause of occupational disease

A more radical criticism of occupationalcompensation is that financial support to adisabled patient depends on causation ratherthan on need.28 This generates a privilegedclass of disabled within the community29 thatis the more illogical when occupationalcausality is only part of the origin of disabilityin an individual subject.

1 Bacon F, 1599. In: FH Anderson, ed. The New Organonand related writings. New York: Bobbs-Merrill, reprinted1960.

2 Hume D. Treatise of human nature. London: John Noon,1739. In: Selby-Biggs LA, ed. Revised and reprinted.Oxford: Clarendon Press, 1985.

3 Popper KR. The logic of scientific discovery. Revised ed. NewYork: Harper and Row, 1968. Originally published as:Logik der Forschung. Vienna: Springer, 1934.

4 Buck C. Poppers' philosophy for epidemiologists. Am JEpidemiol 1975;4: 159-68.

5 Jacobsen M. Against Popperized epidemiology. Int JfEpidemiol 1976;5:9-1 1.

6 Hammond EC. Cause and effect. In: Wynder ES, ed. Thebiologic effects of tobacco. Boston: Little, Brown1955:171-96.

7 Yerushalmy J, Palmer CE. On the methodology of investi-gations of etiologic factors in chronic diseases. J ChronDis 1959;1O:27-40.

8 Surgeon General's Advisory Committee on Smoking andHealth. Rockville, Maryland: Public Health Services;DHEW, 1964. (PHS No 1103.)

9 Hill AB. Principles of medical statistics, 9th ed. London:Lancet 1971:313-23.

10 Fisher RA. Lung cancer and cigarettes. Nature1958;132: 108.

11 Rothman KJ, ed. Causal inference. Chestnut Hill, MA:Epidemiology Resources, 1988.

12 MacClure M. Popperian refutation in epidemiology. Am JEpidemiol 1985;121:343-50.

13 Enterline PE. Attributability in the face of uncertainty.Chest 1980;78:377-9.

14 Lagakos SW, Mosteller F. Assigned shares in compensa-tion for radiation-related cancers. Risk Analysis1986;6:345-57.

15 Honor AM. In: Tunc A, ed. Causation and Remotenessof Damage. International encyclopedia of comparative law.Vol XI Torts, Chapter 7. North Virginia: Kluwer Ac NV,1986:71.

16 Mill JS. A system of logic, ratiocinative and inductive.London: Parker, Son, and Brown, 1872.

17 Wardlaw v Bonnington Castings Ltd. London: House ofLords, 1956 AC613 L(HL).

18 McGhee v National Coal Board. London: 1972; 3 All ER:108.

19 Rothman KJ, Poole C. Science and policy making. Am JPublic Health 1985;75:340-1.

20 Foster KR, Bernstein DE, Huber PW. Science and thetoxic tort. Science 1993;261:1509 and 1614.

21 Huber PW. Galileo's revenge: junk science in the courtroom.New York: Basic, 1991.

22 Frye v United States. District of Columbia: 1923. (293F1013).

23 Daubert v Merrill. Dow Pharmaceutical Inc. 1993;61USLW:4805.

24 Black B, Lilienfeld DE. Epidemiological proof in toxic tortlitigation. Fordham Legal Reviews 1984;52:732.

25 Elliott ED. Why courts? Comment on Robinson. Journal ofLegal Studies 1985 XIV:799-805.

26 Royal Commission on Civil Liability and Compensation.London: HMSO, 1978.

27 Muir DCF. Compensating occupational diseases: amedical and legal dilemma. Can Med Assoc J 1993;148:1903-5.

28 Ison TG. Compensation for industrial diseases under theWorkers' Compensation Act of Ontario. Industrial DiseasesStandards Panel, Government of Ontario.

29 Stapleton J. Disease and the compensation debate. Oxford:Clarendon Press, 1986.

Vancouver styleAll manuscripts submitted to Occup EnvironMed should conform to the uniformrequirements for manuscripts submitted tobiomedical journals (known as theVancouver style.)

Occup Environ Med, together with manyother international biomedical journals, hasagreed to accept articles prepared in accor-dance with the Vancouver style. The style(described in full in the BMJ, 24 February1979, p 532) is intended to standardiserequirements for authors.

References should be numbered consec-

utively in the order in which they are firstmentioned in the text by Arabic numeralsabove the line on each occasion the refer-ence is cited (Manson' confirmed otherreports2-5 . ). In future references topapers submitted to Occup Environ Med

should include: the names of all authors ifthere are seven or less or, if there are more,the first six followed by et al; the title ofjournal articles or book chapters; the titlesof journals abbreviated according to thestyle ofIndex Medicus; and the first and finalpage numbers of the article or chapter.Titles not in Index Medicus should be givenin full.

Examples of common forms of refer-ences are:

1 International Steering Committee of Medical Editors,Uniform requirements for manuscripts submitted tobiomedical journals. BrMedJ7 1979;1:532-5.

2 Soter NA, Wasserman SI, Austen KF. Cold urticaria:release into the circulation of histamine and eosino-phil chemotactic factor of anaphylaxis during coldchallenge. N EnglJ_7Med 1976;294:687-90.

3 Weinstein L, Swartz MN. Pathogenic properties ofinvading micro-organisms. In: Sodeman WA Jr,Sodeman WA, eds. Pathologic physiology, mechanismsof disease. Philadelphia: W B Saunders, 1974:457-72.

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Developments in reproductive risk management

45 Londo M. Implementatie van het voorzorgpnncdpe in deMAC-waarden: speurtocht naar het kritisch effect(Implementation of the precautionary principle in the MACvalues; search for the critical effect). Utrecht: UtrechtUniversity, Department of Science, Technology, andSociety, 1994.

46 Liukko M. Occupational hazards and reproduction. Thirdinternational NIVA course. Health policy of OHS services[lecture]. Turkku: Tikkurila, 1991.

47 Stijkel A, Reijnders L. Implementation of the precaution-ary principle in standards for the workplace. OccupEnviron Med 1995;52:304-312.

48 Zielhuis RL, Kreek FW van der. The use of a safety factorin setting health-based permissible levels for occu-pational exposure. I: a proposal; II: comparison ofextrapolated and published permissible standards. IntArch Occup Environ Health 1979;42:203-15.

49 Paul M, Welch L. Improving education and resources forhealth care providers. Environ Health Perspect 1993;101(suppl 2):191-7.

50 Barlow SM, Sullivan FM. Reproductive hazards of industrialchemicals. London: Academic Press 1982.

51 Zielhuis RL, Stijkel A, Verberk MM, Poel-Bot M van de.

Health risks to female workers in occupational exposureto chemical agents. Int Arch Occup Environ Health 1984(suppl).

52 Fletcher AC. Reproductive hazards of work. Manchester:Equal Opportunities Commission, 1985.

53 Koeter HBWM, Dreef van der Meulen HC, Stijkel A,Zielhuis RL. Schadeldike effected van stoffen op voortplantingen nageslacht anders dan via de inwerking op het erfelijkmaterial, indien deze bekend is. Een literatuurstudie. (Toxiceffects ofsubstances on reproduction and progeny. A literaturestudy). The Hague: Ministry of Social Affairs andEmployment, Directorate General of Labour, 1989.(S73.)

54 Deutsche Forshungsgemeinschaft. MAK- und BAT-werteListed (MAC and TRC value lists). Weinheim: Mitteilung,1994:30.

55 Donald JM. Monserrat LE, Hooper K, Book SA, ChernoffGF. Prioritizing candidate reproductive/developmentaltoxicants for evaluation. Reprod Toxicol 1992;6:99-108.

56 Stijkel A. Reprotox-achtergronddocument (A reprotox back-ground document). The Hague: Ministry of Social Affairsand Employment, Directorate General of Labour, 1992.(S138-2.)

Instructions to authorsThree copies of all submissions should besent to: The Editor, Occupational andEnvironmental Medicine, BMJ PublishingGroup, BMA House, Tavistock Square,London WC1H 9JR, UK. All authorsshould sign the covering letter as evidenceof consent to publication. Papers reportingresults of studies on human subjects must beaccompanied by a statement that thesubjects gave written, informed consentand by evidence of approval from theappropriate ethics committee. These papersshould conform to the principles outlinedin the Declaration of Helsinki (BMJ 1964;ii:177).

If requested, authors shall produce thedata on which the manuscript is based, forexamination by the Editor.Authors are asked to submit with

their manuscript the names andaddresses of three people who theyconsider would be suitable independentreviewers. They will not necessarily beapproached to review the paper.Papers should include a structured

abstract of not more than 300 words,under headings of Objectives, Methods,Results, and Conclusions. Pleaseinclude up to three keywords or keyterms to assist with indexing.

303

Stijkel, Reijnders

4 Bus J, Posthuma J, Broekhuizen PC van, Stijkel A,Ulenbelt P. MAC-waarden op de arbeidsplaats (MAC-values at the workplace). Alphen aan den Rijn: SamsonHD TjeenkWillink, 1992:34-41.

5 Landelijk Milieu Overleg (LMO). Brief aan de Minister vanSociale Zaken en Werkgelegenheid betreffende de EG-richtlijn zwangeren in relatie tot milieu en gezondheid (Letterto the Minister of Social Affairs and Employment concerningthe EC directive pregnant workers). Utrecht: LMO, 1992.(U-LMO-92-107.)

6 Landelijk Milieu Overleg (LMO). Brief aan de Minister vanSociale Zaken en Werkgelegenheid betreffende verlagingdioxine norm en ontwerpbesluit zwangere werkneemsters(Letter to the Minister of Social Affairs and Employmentconcerning lowering the dioxin norm and the conceptMinisterial Order pregnant workers). Utrecht: LMO 1993.(U-LMO-93-161.)

7 United Nations conference on environment and develop-ment (UNCED). Declaration of Rio. Rio de Janeiro,Brazil: UN 1992. (Principle 15.)

8 Commission of the European Communities (CEC).Directive of the Council concerning the classification of haz-ardous substances. Brussels: CEC 1967. (67/548/EEC.)

9 Commission of the European Communities (CEC).Directive of the Council concerning the eighteenth amend-ment to Directive 671548/EEC. Brussels: CEC, 1993.(93/21 /EEC.)

10 Commission of the European Communities (CEC).Directive of the Council concerning the protection against therisks of exposure to carcinogenic substances at work.Brussels: CEC, 1990. (90/394/EEC.)

11 Commission of the European Communities (CEC).Directive of the Council concerning the protection at work ofpregnant women or women who have recently given birth.Brussels: CEC, 1992. (92/85/EEC.)

12 Arboraad. Advies inzake grenswaarden voor genotoxischcarcinogens stoffen (Advice concerning standard setting forgenotoxic carcinogenic substances). Zoetermeer: Arboraad,1992.

13 Deutsche Forshungsgemeinschaft. MAK- und BAT-werteListe (MAC- and TRC-value lists). Weinheim, 1994.(Mitteilung 30.)

14 Arbeidsinspectie. Werken met kankerverwekkende stoffen enprocessen (Working with carcinogenic substances andprocesses). The Hague: Ministry of Social Affairs andEmployment, 1994:187.

15 Dijk-Looijaard AM van. Herziening normen drink-waterbesluit (Readjustment water supply directive concerningguidelines). Niewegein: KIWA, 1993. (SWO93.340.)

16 Stijkel A. Een reprotoxinstrument (A reprotox instrument).The Hague: Ministry of Social Affairs and Employment,Directorate General of Labour, 1992:S138- 1.

17 Barlow SM, Sullivan FM. Reproductive hazards of industrialchemicals. London: Academic Press, 1982.

18 Zielhuis RL, Stijkel A, Verberk MM, Poel-Bot M van de.Health risks to female workers in occupational exposureto chemical agents. Int Arch Occup Environ Health1984;suppl: 120.

19 Fletcher AC. Reproductive hazards of work. Manchester:Equal Opportunities Commission, 1985.

20 Koeter HBWM, Dreef van der Meulen HC, Stijkel A,Zielhuis RL. Schadelijke effecten van stoffen op voortplantingen nageslacht anders dan via de inwerking op het erfelijk

materiaal, indien deze bekend is. Een literatuurstudie.(Toxic effects of substances on reproduction and progeny.A literature study). The Hague: Ministry of SocialAffairs and Employment, Directorate General ofLabour, 1989, (S73).

21 Donald JM, Monserrat LE, Hooper K, Book SA, ChernoffGF. Prioritizing candidate reproductive/developmentaltoxicants for evaluation. Reprod Toxicol 1992;6:99-108.

22 Koeter HWBM. Relevance of parameters related to fertilityand reproduction in toxicity testing. Am 7 Ind Med1983;4:81-6.

23 Londo M. Implementatie van het voorzorgprincipe in deMAC-waarden: speurtocht naar het kritisch effect(Implementation of the precautionary principle in the MAC-values; search for the critical effect). Utrecht: UtrechtUniversity, Department of Science, Technology, andSociety, 1994.

24 National Institute for Occupational Safety and Health.CD-rom database: registry of toxic effects of chemicalsubstances (RTECS) update. Cincinnati: NIOSH, 1993.

25 Paul M, Welch L. Improving education and resources forhealth care providers. Environ Health Perspect 1993;101(suppl 2):191-7.

26 Zielhuis RL, Kreek FW van der. The use of a safety factorin setting health based permissible levels for occu-pational exposure. I: a proposal; II: comparison of extra-polated and published permissible standards. Int ArchOccup Environ Health 1979;42:203-15.

27 Stijkel A, Verberk MM. A proposal for systematicallydrafting health-based recommended occupational expo-sure limits (HBR-OEL) illustrated on reproductivetoxicity. In: Stijkel A. On managing reproductive risks ofoccupational exposure to chemicals. Amsterdam: Universityof Amsterdam, Coronel Laboratory, 1995. (Thesis inpreparation.)

28 Sullivan F. Occupational hazards and reproduction. Thirdinternational NIVA course. Lecture: EU criteria.Turkku, 10 November 1994. .7 Occup Med 1995; (inpress).

29 Taskinen H. Prevention of reproductive health hazards atwork. Scand Y Work Environ Health 1992;18(suppl2):27-9.

30 Taskinen H. Occupational hazards and reproduction.Third international NIVA course. Lecture: Nordiccriteria. Turkku, 10 November 1994. Y Occup Med 1995;(in press).

31 Stijkel A. Vergelijkend warenonderzoek databestanden mbtreprotox (Comparison of databases concerning reproductiverisks) internal report. Amsterdam: University ofAmsterdam, Coronel Laboratory, 1991.

32 Gezondheidsraad. Advies inzake uitgangspunten voornormstelling (Advice concerning starting points for standardsetting). The Hague: Gezondheidsraad, 1985.

33 Mik G de. De advieswaarden: wikken en wegen (Theguidelines: a weighing process). Tijdschrift voor SocialeGezondheidszorg 1993;71:120-1.

34 Commission of the European Commission (CEC). Healthand safety, occupational exposure limits, criteria documents.Guidance note on the content and layout. Brussels: Healthand Safety Directorate, 1992.

35 Arbeidsinspectie. De national MAC-lijst (The nationalMAC-list). The Hague: Ministry of Social Affairs andEmployment, Directorate General of Labour, 1994:145.

Correspondence and editorialsOccupational and Environmental Medicine wel-comes correspondence relating to any of thematerial appearing in the journal. Resultsfrom preliminary or small scale studies mayalso be published in the correspondencecolumn if this seems appropriate. Lettersshould be not more than 500 words in lengthand contain a minimum of references. Tablesand figures should be kept to an absolute

minimum. Letters are accepted on theunderstanding that they may be subject toeditorial revision and shortening.The joumal also publishes editorials which

are normally specially commissioned. TheEditor welcomes suggestions regardingsuitable topics; those wishing to submit aneditorial, however, should do so only afterdiscussion with the Editor.

312

Ocular effects of exposure to triethylamine in the sand core cold box of a foundry

at work or while driving home because ofdifficulty in seeing indicates a need to min-imise exposure to triethylamine below thosestandards currently considered acceptable.Given that 59% of the workers experiencedsymptoms at or below the recommendedACGIH concentration at the time of our

study, our data would support the new

lower recommended ACGIH concentrationof 4d1 mg/M3.

The project was funded by joint funds from the UAW andChrysler National Joint Committee on Health and Safety. Theresults represent the conclusions and opinions of the authors. Itspublication does not necessarily imply endorsement by theInternational Union UAW, or Chrysler Corporation.

1 Albrecht W, Stephenson R. Health hazards of tertiaryamine catalysts. Scand Work Environ Health 1988;14:209-19.

2 Brieger H, Hodes WA. Toxic effects of exposure to vapors

of aliphatic amines. Archives of Industrial Hygiene 1951;3:287-91.

3 Akesson B, Floren I, Skerfving S. Visual disturbances afterexperimental human exposure to triethylamine. Br IndMed 1985;42:848-50.

4 Akesson B, Bengtsson M, Floren I. Visual disturbancesafter industrial triethylamine exposure. Int Arch OccupEnviron Health 1986;57:297-302.

5 Mellerio J, Weale RA. Miscellanea: hazy vision in amineplant operatives. BrJInd Med 1966;23:153-8.

6 Stahlbom B, Lundh T, Floren I, Akesson B. Visual distur-bances in man as a result of experimental and occupa-tional exposure to dimethylethylamine. Br Ind Med1991;48:26-9.

7 US Department of Health and Human Services, PHS,CDC, NIOSH. NIOSH alert: report for assistance in pre-venting vision disturbances and acute physical distress due todimethylethylamine (DMEA) exposure. Washington:NIOSH, 1987.

8 Warren Jr D, Selchan D. An industrial hygiene appraisal oftriethylamine and dimethylethylamine exposure limits inthe foundry industry. Am Ind Hyg Assoc 1988;49:630-4.

9 Hansen F. A clinical study of the normal human centralcorneal thickness. ACTA Ophthalmol 1971;49:82-9.

10 Kremer F, Walton P, Gensheimer G. Determination ofcorneal thickness using ultrasonic pachometry. AnnOphthalmol 1985;17:506-7.

Rejected manuscriptsFrom February 1994, authors whose sub- be returned to them. The Jounal will destroyemitted articles are rejected will be advised of remaining copies of the article but corres-the decision and one copy of the article, pondence and reviewers' comments will betogether with any reviewers' comments, will kept.

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Occupational and Environmental Medicine 1995;52:359-360

NOTICES

Eleventh International Symposium onEpidemiology in Occupational Health.Noordwijkerhout, within easy reach ofAmsterdam, The Netherlands. 5-8September 1995.

The conference will be organised by theDepartments of Epidemiology and PublicHealth and Air Quality of the AgriculturalUniversity Wageningen, The Netherlands,and Department of Public Health ofErasmus Univesity Rotterdam, TheNetherlands, on behalf of the ScientificCommittee on Occupational Epidemiology,of the International Committee onOccupational Health (ICOH).

This Symposium will offer an excellentinternational platform to exchange know-ledge on occupational epidemiology. Itbrings active research workers in occupa-tional epidemiology together who review thestate of the art concerning major and cur-rent issues in the field of occupationalhealth; methodology, findings, and applica-tions of their work will be discussed.The ICOH launched in 1980 a successful

tradition of providing a world wide forum tofoster exchange among researchers.The programme will include plenary and

parallel sessions with invited and submittedpapers related to the following themes:* Methods in occupational epidemiology* Occupational surveillance methods, eval-

uation, and ethical aspects* Occupational diseases* Occupational injuries* Occupational cancer* Neurological effects* Respiratory diseases* Musculoskeletal disorders* Reproductive and developmental effects* Work related stress* Exposure assessment in occupational

epidemiology* Biomarkers* Communicable diseases at work* Occupational epidemiology.For any inquiries or assistance, please

contact the conference secretariat: MsSusan Peelen Msc, Department of Epide-miology and Public Health, University ofWageningen, PO Box 238, 6700 AEWageningen, The Netherlands. Tel: +318370 84124; Fax: +31 8370 82782; e-mailsusan.peelen~medew.hegl. wau.nl.

Annual Conference of the InternationalSociety for Environmental Epide-miology and the International Societyfor Exposure Analysis. 30 August-1 September 1995. Noordwijkerhout,The Netherlands.

The conference unites people working inenvironmental epidemiology and exposureassessment to exchange information andsynthesise ideas, about the methodology,results and applications of their research. Itwelcomes epidemiologists, exposure asses-sors, toxicologists, environmental healthofficials, and others interested in the field.The focus of this 7th ISEE/5th ISEA

conference will be on methodology toimprove the assessment of the public healthimpact of environmental pollution at the(inter)national and regional level.

Major symposia are foreseen on the fol-lowing subjects:* Integrating exposure assessment and epi-

demiological methods to improve studydesign in environmental epidemiologyand health impact assessment

* Multi-centre studies in environmentalepidemiology: methodological aspects,and results of a number of recent studiesconducted in Europe and elsewhere

* Uses of exposure assessment and envi-ronmental epidemiology in public healthat the state, regional, and local level.The programme will feature a number of

oral and poster sessions on, among others,the following themes:* Monitoring and surveillance* Biological contaminants* Exposure assessment* Air pollution* Environmental equity* Risk assessment* Genetic susceptibility* Molecular epidemiology* Water quality* VOC* Metals* Multi-centre studies* Adversity of health effects* Pesticides* Hazardous wastes* Motor vehicle emissions* Chronic diseases* Reproductive health* Allergy and other immunological effects* EMF* RadonFor any inquiries or assistance, please

contact the conference secretariat: MsSusan Peelen Msc, Department of Epide-miology and Public Health, University ofWageningen, PO Box 238, 6700 AEWageningen, The Netherlands. Tel: +318370 84124; Fax: +31 8370 82782; e-mailsusan.peelengmedew.hegl. wau.nl.

Quality and audit in OccupationalHealth Services-International Conferenceon Health Services Research inOccupational Health. 22-24 November1995. Glynhill Hotel, Renfrew, Glasgow.

This conference is organised jointly by theICOH Scientific Committee on HealthServices Research and Evaluation inOccupational Health, in association withthe United Kingdom Faculty and Society ofOccupational Medicine, Society of Occu-pational Health Nurses, British Occupa-tional Hygiene Society, and EuropeanAssociation of Schools of OccupationalMedicine.The evaluation of occupational health

services and the quality of services providedis increasingly important for occupationalhealth professionals, for purchasers of ser-vices and for workers. This important con-ference will provide an opportunity for thedissemination of research and best practice.It will include keynote presentations, freepaper sessions, and workshops.

Papers are invited on the followingthemes:* Health Services research* Auditing and evaluation of occupational

health services* Performance measurements in occupa-

tional health and safety including cost/benefit analysis

* Quality improvement* The role of external quality standards to

occupational health services* Evaluating continuing professional

development and education in occupa-tional health.Keynote presentations will include:

Dr J T Carter-Director of FieldOperations, Health and Safety ExecutiveProfessor Dr P Westerholm-ChairmanICOH Scientific Committee on HealthServices ResearchDr R Agius-President Elect BritishOccupational Hygiene SocietyProfessor Dr K Husman-Institute ofOccupational Health, Finland.Social programme includes: conferencedinner; Scottish evening; whisky tasting andrelated scientific activities.

Abstract, in English, of no more than 250words for 15 minute presentation, andposters should be submitted with yourregistration form and £70 registration feeby 1 June 1995.

For further information contact: DrEwan B MacDonald, Department of PublicHealth, 2 Lilybank Gardens, University ofGlasgow, Glasgow G12 8RZ. Tel: +44 (0)141 330 4038. Fax: +44 (0) 141 330 5018.

BOOK REVIEWS

Book review editor: R L Maynard

If you wish to order, or require furtherinformation regarding the titles reviewedhere, please write or telephone the BMJBookshop, PO Box 295, London WC1H9TE. Tel: 0171 383 6244. Fax: 0171 3836662. Books are supplied post free in theUK and for British Forces Posted Overseasaddresses. Overseas customers should add15% for postage and packing. Payment canbe made by cheque in sterling drawn on aUK bank, or by credit card (MasterCard,VISA, or American Express) stating cardnumber, expiry date, and your full name.(The price and availability are occasionallysubject to revision by the Publishers.)

Indoor Air Pollution. Problems andPriorities. GB LESLIE, FW LANAU eds. (PP329; price C17-95). 1994. Cambridge:Cambridge University Press. ISBN 0-521-47794-8.

It is now increasingly recognised thatconcentrations of air pollutants indoors arebetter predictors of exposure and healtheffects than outdoor concentrations. Thisreflects both the time spent indoors by mostof the population, especially the more vul-nerable groups of infants, elderly, andchronically sick people, and the relativeimportance of indoor sources of pollu-tants such as nitrogen dioxide, carbonmonoxide, environmental tobacco smoke,and radon.

This book sets out to provide a balancedaccount of the problems arising from indoorair pollution, on a pollutant by pollutantbasis. Its strength lies in the scope of itscoverage. Problems of indoor air pollutionin domestic buildings in affluent countriesare considered alongside those in the devel-oping countries. The nature and scale of theproblems caused by inappropriate heating

359