bookrev.qk A 344 VOLUME 113 | NUMBER 5 | May 2005 • Environmental Health Perspectives The Bhopal Saga: Causes and Consequences of the World’s Largest Industrial Disaster By Ingrid Eckerman Hyderabad, India:Universities Press, 2005. 283 pp. ISBN: 81-7371-515-7. Rs250 After 20 years, victims, health care work- ers, and governments are still trying to comprehend what has been called the world’s worst industrial accident. The Bhopal Saga is an attempt to bring order from the chaos of events before, during, and after the methyl isocyanate (MIC) release. Not a scientific analysis, the book summarizes events leading up to the accident of December 1984 and the relief work in the ensuing two decades. Eckerman’s primary strength is her on-scene experience as a mem- ber of the International Medical Commission on Bhopal. She describes comprehensively the long-term health effects documented in the exposed population and suggests what might be done to improve health care for the victims. The paucity of data on certain end points, notably women’s reproductive health, childhood outcome, and cancer, is stressed. Also included is a summary of the positive and negative effects of various interim relief efforts on the population. Eckerman includes societal, economic, environmental, and political aspects that she consid- ers imperative for integrated long-term health care. The range of acute and chronic health effects in the exposed popu- lation is placed in terms of the toxicity of the probable major compo- nents of the gas cloud. Unfortunately, Eckerman relied on secondary sources for this information, although the database for most of the indi- vidual chemicals is robust and contains controlled experiments in both humans and animals. The primary literature would have informed her that beyond contact irritation, toxicity of the isocyanates varies widely. For example, MIC is not a sensitizer and causes systemic toxicity, whereas other isocyanates are potent sensitizers and local irritants only.