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Occup Environ Med. 2007 August; 64(8): 561.
PMCID: PMC2078488

Inhalation toxicology

Reviewed by R L Maynard

H Salem, S H Katz. Taylor and Francis, 2006, £109, ISBN 0-8493-4049-7

This is a big book that tells you a lot about inhalation toxicology. The editors clearly intend it to be a definitive work and it is aimed both at practising inhalation toxicologists and the “aspiring student”. As a reference work for the professional it succeeds well; of its value as a textbook for students I am less certain. About 70 authors have contributed, and there are 40 chapters of varying length. Some deal with the theoretical aspects of the subject, some with regulatory matters and others with compounds or groups of compounds. It is not possible to discuss more than a few chapters in detail.

The first section deals with “Methods and Measurements”. The second, confusingly, deals with “Methods” again. No systematic approach seems to have been taken. Chapter 5 for example, provides an interesting account of the rather arcane subject of vapour exposure to the organophosphorus compound VX. This is fascinating for those, like the reviewer, with an interest in CW agent toxicology. But we are not told why this is important: who is at risk? The chapter discusses Haber's Rule, an important concept, and uses VX as an example of deviation from the rule. A full discussion, from a more general standpoint, early in the book would be useful as this topic comes up again and again in later chapters. Animal models are clearly important and Brown and colleagues have contributed a valuable account of a large animal model. Phosgene is used as an example of a compound that can be studied using such a model. I enjoyed reading this: the inclusion of detailed physiological methods in a toxicology study is encouraging and the authors have provided results which are difficult to find elsewhere, though the latter parts of the chapter read more like a research paper than a textbook account. The provision of information of the advantages and disadvantages of large animal models is, however, limited. Chapter 8 returns to Haber's Rule with force: a range of models is discussed. This is excellent but surely it should have appeared earlier in the book. Levin and Kuligowski have written a valuable chapter on the toxicology of fire and smoke. This discusses the “N‐Gas” model but no clear link with the discussion of models in chapter 8 is provided. In the second part of the book, “Methods”, Calabrese discusses hormesis (is this a method?), and detailed accounts of the toxicology of, for example, riot control agents and CW compounds are provided. The editors may have regarded these as providing examples of specific methods—I was unconvinced. In the third section Ballantyne and Salem have contributed a magisterial account of the toxicology of cyanides. This runs to about 90 pages and is exhaustively referenced: a quick count suggests about 500 citations; one might wonder what of importance has not been listed! McGrath, on the other hand deals with carbon monoxide rather briefly and provides no discussion of the possible long‐term effects of exposure to subsymptomatic concentrations. Toxins and bio‐aerosols are dealt with in the final section. Ricin and botulinum toxin command chapters of only about 10 pages—very short in comparison with other chapters. As far as I can see, no discussion of the inhalation toxicology of air pollutants is provided—a significant omission. Also, the fast growing field of nano‐particle toxicology is not included. This is a pity as a proper discussion of methods for generating nano‐particle aerosols and of the peculiar properties of these substances would be useful at present.

In conclusion: a big book with many important contributions, some unique and reflecting the special interests of the authors. However, the organisation and balance could be improved. All professional inhalation toxicologists will want a copy: the price, by today's standards, is very reasonable. Students learning the subject will struggle with this book, will find it daunting in places and will need to turn to other works. The need for a proper textbook of inhalation toxicology remains, I think, unmet. To anybody with a special interest in the compounds discussed at length, including CW agents, it will be indispensable: I am very glad to have a copy!


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