For at least 24 centuries, since Hippocrates wrote his treatise Air, Waters, Places, we have appreciated that inhalants can affect pulmonary health. The last few years have seen a profusion of books on various aspects of occupational and environmental lung disease; entire books address subdisciplines, such as radiology and pathology, and specific exposures, such as asbestos and beryllium. We now have yet another major text that surveys the entire field, joining two standard texts—Parkes' Occupational Lung Disorders (1994) and Morgan and Seaton's Occupational Lung Diseases (1995), both just released in their third editions—and several older texts published in the 1980s.

The newest contribution, Occupational and Environmental Respiratory Disease, differs in several ways from its predecessors. It is bigger: 1038 pages compared with 892 in Parkes and 657 in Morgan and Seaton. It is distinctly North American in flavor; the other texts have British pedigrees. Most importantly, it covers more territory. The extension to environmental topics is notable and timely; useful chapters are included on outdoor and indoor air pollution, environmental tobacco smoke, and related topics omitted in the other texts. There is excellent coverage of policy issues, industrial hygiene (including both measurement of hazards and prevention through engineering changes and respirators), public health initiatives such as workplace screening and risk communication, and clinical issues such as impairment ratings and pulmonary rehabilitation. In the aggregate, these provide a broad, thorough overview of the field that is unrivalled.

To achieve this breadth, the editors called on a who's who of eminent authors (no fewer than 100, compared with 20 in Parkes and 10 in Morgan and Seaton). For the most part, the editing is good, and the usual discontinuity of multiauthor texts is kept to a minimum. The editors also chose a unique structure. Previous texts have started with chapters on general topics such as lung physiology, epidemiology, and prevention and then have proceeded to a series of chapters on each of the major diseases (such as silicosis, occupational asthma, and hypersensitivity pneumonitis), with occasional chapters on exposures. This text does include chapters on major disease categories, but they are relatively short. Most of the information appears in chapters organized according to exposures, including specific agents (for example, asbestos, cotton dust, metals, and environmental tobacco smoke) and entire industries or processes (such as agriculture, welding, and electronics). Thus, whereas previous texts have had 20 or 25 chapters, this one has 61. The book includes useful "features" that have become standard, including a glossary of abbreviations, an annotated bibliography of works on occupational asthma, and chapters on aerospace and high-pressure environments. It is affordable at $139.00; Parkes costs $225.00, and Morgan and Seaton costs $85.00.

There are some drawbacks. Most importantly, depth-in both text and graphics—has been sacrificed for breadth, especially with regard to specific diseases. Beryllium disease merits only 3 pages and no radiologic or pathologic illustrations; Parkes devotes 22 pages to this important topic and provides excellent graphics. Coal workers' pneumoconiosis is discussed in 11 pages, again without clinical images; Parkes offers a 72-page chapter with numerous indispensable radiographs and photoµgraphs. The index could be more complete; the ratio of pages of index to pages of text is 1:86, compared with 1:49 in Parkes and 1:43 in Morgan and Seaton. Such terms as "sinusitis," "acid aerosol," and "bronchoalveolar lavage" do not appear.

This is a comprehensive, well-organized, expertly written book. Its coverage of general environmental exposures, policy, air measurement, prevention, and other topics beyond the narrowly clinical is unsurpassed. Because its discussions of specific diseases are in some cases brief, and because it contains few clinical graphics, many readers will want other occupational pulmonary books as well. However, no library of occupational medicine will henceforth be complete without this excellent text.