By Phil Brown. Foreword by Lois Gibbs . Published by Columbia University Press . Hardback , 392 pages with index . RRP $A52.95 . ISBN: 978-0-231-12948-0 .

Reviewed by Liz Hanna

National Centre for Epidemiology & Population Health, Australian National University, ACT

Phil Brown's book Toxic Exposures: Contested Illnesses and the Environmental Health Movement covers new ground. His previous work No Safe Place: Toxic Waste focused more on the impacts of chemical exposures. In Leukaemia and Community Action he turned to describing the community campaign. This latest work extends beyond an outline of the exposure pathway and subsequent impacts on the exposed, to an examination of the battles faced by community groups who advocate for legislative responses. By contrasting three disorders, Asthma, Breast Cancer and Gulf War Syndrome, Brown teases out the differences played by features such as scientific certainty in chemical causation and the power of the community support on having a successful impact on legislative action.

Environmental health researchers and practitioners, plus advocates across all public health spheres would benefit from reading Brown's newest book. Toxic Exposures has broad application to public health as it examines the difficulties in achieving positive outcomes from 360 degrees. Brown explores the dilemma of contested illnesses arising from chemical exposures from the perspectives of an individual's experience of illness. He gives insight into the drivers for community held views of distrust of authorities, business and the scientific process. Another angle explored is the difficulties facing workers whose role it is to minimize and rectify the harm associated with chemical exposure. Examples of corporate resistance and frank harassment by chemicals companies are given, and the economic influence of large companies that contribute to regulatory gridlock are explained. Also, challenges facing epidemiology, public health agencies and researchers working in this field are discussed.

Of specific relevance to public health is the demonstration of the effectiveness of synergies of collaboration. Examples include researchers connecting with community groups, which led to the establishment of a recognised paradigm of working, and where researchers are professionally rewarded, and the community's wishes come to fruition. Another is the additional power given to regulatory authorities and community services resulting from demonstrations of broad community support for an issue. In so doing, the book describes public health in action. Advocacy, by community members and public health professionals can shape policy.

The world of toxic battles in an impassioned one. Advocates realistically feel as thought they are fighting for their life, or the life of their loved ones. Texts on this issue range from emotive personal accounts with variable recourse to evidence and laments about bureaucratic inertia, through to scientific texts on toxicological outcomes arising from exposure. Emotive accounts have their objectivity questioned, yet it is difficult to not be touched by the plight of sufferers. The project here is an ambitious one, finding a balance between the far ends of the continuum. Brown manages to weave through this dilemma by maintaining consistency, presenting a well-researched factual account and drawing illuminating contrasts. Quotes are used to provide insight into the views from key stakeholder groups.

Scholarly in its approach, and detailed referencing, yet the dialogue provides an easy reading style well-suited for undergraduates, and interested lay public. The artful composition of this complex issue provides sufficient intellectual depth to warrant inclusion on postgraduate reading lists. The cost of covering a broad scan is often the inevitable brevity of each section. However, Brown has worked each section sufficiently to give an understanding on the complex chemicals management and regulatory environment, in addition to a deep understanding of various merits and strategies for effective advocacy.

Limitations for the book's application to Australians lie in its setting being the US. The battles are located in Legislative Frameworks that differ in Australia, yet although the names of the regulatory bodies may differ, and the breadth and experience of advocacy groups far exceeds Australia's capacity, the operational climate of Government Authorities, academic institutions, and big business share so many similarities that most lessons translate well.

Phil Brown is Professor of sociology and environmental studies at Brown University, and co-editor of Social Movements in Health and Illness. I recommend this informative accessible text.