Michael McCally, Life Support: the Environment and Human Health.

Cambridge, MA: MIT Press, 2002. $19.95. papercover. Human health and the environment are unequivocally linked. As human society continues to grow and develop, its impact on the environment increases. Air and water pollution, radiation, and artificial chemicals in food are daily realities. Research on the human health risks of exposure to pollutants has shown significant negative health impacts associated with these exposures. But, outside of researchers and health professionals focused on studying the links between health and the environment, there is little public understanding of these issues. This book, edited by Michael McCally, attempts to bridge the knowledge gap by offering thorough descriptions of the health effects of environmental pollutants.

The book consists of seventeen chapters covering a range of topics important to understanding humankind's impact on the natural environment and how those impacts affect human health. The most powerful chapter is chapter one, written by the editor. In this chapter the connection between human health and the environment is succinctly described. McCally cautions," ... interactions between poverty, population growth, and environmental degradation impede sustainable economic development and worsen population health." Chapters two through twelve concisely address the issues of air pollution, water quality, global climate change, loss of species and ecosystems, ozone depletion and radiation, and the relationship between cancer and the environment, heavy metal exposure, endocrine disruption, and the body burden of industrial chemicals. Each chapter offers a description of current research in an area and recommendations for courses of action to address the concern.

The next four chapters cover more technical and evaluative issues including risk assessment, the precautionary principle, vulnerable populations, and the impact of war on the environment. Chapter thirteen, addressing risk assessment, is far too short for such a complex topic and offered only a cursory discussion of the intricacies involved in the assignment of risk and the need for public understanding of risk. Chapter fourteen discusses the precautionary principle which states that even in the face of scientific uncertainty, the threat of significant public health risks should be addressed through precautionary action to counter the threat. The chapter thoroughly addresses the complex interplay of ethics, science, values and biases in formulating responses to possible environmental hazards. The discussion of vulnerable populations in chapter fifteen focuses on occupational hazards and the vulnerability of children to toxic exposure. The book concludes with a discussion of the ethical responsibilities of the health care professions to coordinate environmental ethics into their worldview.

The chapters in Life Support are written by medical professionals and is focused on human health-based arguments for environmental sustainability. The concise description of the issues and the brevity of the chapters make this text particularly approachable. Health and social service professionals will appreciate the thorough discussion of important health and social justice related environmental topics. The book will also be of value to other professionals interested in a thorough overview of these important environmental health issues.