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Hunter's Diseases of Occupations. PJ Baxter, PH Adams, T-C Aw, A Cockcroft, JM Harrington, Editors. (Pp 1001, hardback; £155.00). UK: Arnold, 2000. ISBN 0 340 67750 3
In 1955 the first edition of Donald Hunter's bookDiseases of Occupations was published. He said that he wanted to emphasise the clinical aspects of occupational disease and this remains true in the ninth edition of “Hunter's”. The five main editors of this edition and the majority of contributors are UK based. However, given that its primary focus is clinical information, its contents ought to be valid worldwide. Clearly, for issues relating to country-specific health legislation, you may need to look elsewhere (although UK readers are catered for reasonably well).
The 1001 pages of this edition of Hunter's are divided into 11 chapters (parts) with each part being divided into further subsections. Five of the parts are covered sufficiently with one or two subsections (‘Reproduction at work’, ‘Occupational cancer’, ‘Occupational diseases of the skin’, ‘Diseases associated with microbiological agents’, and ‘Diseases related to ergonomic and mechanical factors’), but the chapter on ‘Diseases associated with physical agents’ requires nine subsections. The larger chapters include ‘Diseases associated with chemical agents’ (over 200 pages), ‘Diseases associated with physical agents’ (170 pages), and ‘Occupational lung disorders’ (132 pages). This edition adds in a chapter on ‘Nephrotoxic, neurotoxic, hepatotoxic and haemopoietic effects of workplace exposures’ that is useful in compiling a differential diagnosis list for work related possibilities. The index itself is a healthy 74 pages with a reasonable amount of cross referencing but, if the book was available as a CD-ROM, it would be even better; reference books should embrace this useful technology.
Hunter's has some particularly readable sections which give the salient facts and information embellished with nuggets of background or historical data on the condition or disease. For example, the section on ‘Hand-arm vibration’ covers diagnosis, treatment/management, current techniques for objective testing with comments on specificity and sensitivity, and just enough on the physics of vibration. It also points out that the adverse health effects were recognised by 1918—all this is contained in eight pages supported by four figures, three tables, and 100 references.
What was the book like over a three month period of use? I would dip into it for a specific query and find myself enticed into further pages of reading. Perhaps this was because of writing this review but, equally, the prose around the primary information held my attention. Questions I asked included “Do mobile phones cause cancer?” Hunter's says “no . . . causal link”, “electric and magnetic fields does (sic) not function as either a mutagen or a complete carcinogen” and “it is clear that EMF do not pose a large public health or occupational hazard”. This was useful when dealing with a worried well patient.
What is missing from this book? A CD-ROM version, email addresses for the contributors, and a list of established occupational health internet sites. Hunter's is a “must have” for the bookshelf of any self-respecting occupational physician—I had already obtained my own copy before receiving the review copy. It should be useful for GPs and hospital physicians dealing with a possible occupationally related diagnosis or help to exclude it. Lawyers will have a copy and, if you are involved in tribunals or medicolegal reports, so should you. Its strength is to be clinically comprehensive both in range (from the very obscure to the more common occupational disorders) and in depth, as well as offering practical advice on management. Hunter's is a good book worthy of a personal (albeit expensive) copy. Buy it if you are frequently or infrequently asked the question “Is it my work doctor?”.—SK
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