Abstract
At the same time I was preparing this book review on Aerobiology—The Toxicology of Airborne Pathogens and Toxins (ATAPT), I read in the lay press that on August 19, D. A. Henderson, MD, had died. 1 As soon as I learned of Dr Henderson’s passing, I checked “Chapter 2 Orthopoxviruses and Animal Models for Pathogenesis, Vaccine and Drug Studies” to assure myself that he was recognized for his contribution to medicine and for being responsible for leading the campaign of eliminating a terrible infectious disease. Indeed he was, but it would have been difficult to ignore his contribution since it was historic and monumental. The chapter’s seventh reference was a book Dr Henderson coedited and published almost 30 years ago, entitled “The Pathogenesis, Pathology and Immunology of Smallpox and Vaccinia Smallpox and its Eradication.”
Any discussion of smallpox must be liberally sprinkled with Dr Henderson’s name. He led the army of scientists and clinicians that eradicated the worldwide scourge of smallpox, which over 3,000 years caused the death of an estimated 2 million people per year, that is, a staggering 6.0 × 109 lives lost to smallpox. I am humbled to dedicate this review of ATAPT to Dr Donald Ainslie Henderson (September 7, 1928–August 19, 2016).
Aerobiology—The Toxicology of Airborne Pathogens and Toxins is a gift to all toxicologists just as Dr Henderson’s leadership on smallpox eradication was a gift to medicine and humanity. The toxicologists’ friend is The Royal Society of Chemistry (RSC). 2 The RSC has an extensive journal and book publishing effort and 1 part of that effort is a 25-title series called “Issues in Toxicology.” 3 With a simple registration process, many of the chapters in the series are open access. 4 If, however, a desired chapter does not have an open access option, then the desired individual chapter can be purchased without purchasing the entire book. While there are 25 titles in the toxicology section, there are over 1,500 books available to toxicologists who register. Many of these other titles and subjects, which are not part of the Issues in Toxicology collection, would be available to toxicologists, for example, Advances in Dermatological Sciences, Drug Design Strategies: Computational Techniques and Applications, Food Allergy and Intolerance: Current Issues and Concerns, Metabolic Profiling: Disease and Xenobiotics, and many more titles. We toxicologists should tip our collective chapeaux to our colleagues in the RSC.
A limited view of aerobiology is described as the “study of living organisms and their components in air.” 5 In the first chapter, ATAPT expanded the definition of aerobiology to include biologic components in the atmosphere. With this expanded definition, aerobiologic investigations can address a more comprehensive list of potential toxins. Consequently, aerobiology covers everything from inhalation toxicology, environmental toxicology, and presently or formerly living matter in the outer limits of the atmosphere.
Aerobiology became a scientific discipline with the founding of the International Association of Aerobiology (IAA) in 1974. 6 However, within the IAA and the scientific research community, there seems to be a lack of adequate attention for the biologic component of aerobiology. When I searched PubMed 7 for “aerobiology,” there were only 310 articles, 31 of which were review articles. When “bacteria,” “virus,” and “toxin” were added as filter terms to “aerobiology,” the number was reduced to 118, 29, and 20, respectively. Yet, aerobiology either as a search term or as a research interest is important, especially to toxicologists. At the same time, the term “aerobiology” has not been adopted or used extensively.
Aerobiology—The Toxicology of Airborne Pathogens and Toxins contains over 480 pages within 14 chapters. The 3 longest chapters “Inhalational Anthrax—Issues in Dose-Response and Hazard Evaluation,” “Bacillus anthracis: An Aerobiological Threat,” and “An Improved Model of Human Response to Bioaerosol Exposure” constitute 40% of the book. The remaining chapters cover poxviruses, botulinum neurotoxicity, ricin, bioaerosol measurements, sample collection and management, biologic warfare perspectives, physics of bioaerosols, respiratory protection, human responses to bioaerosol exposures, development of standard operating procedures for responding to toxic bioaerosols, and modeling for bioaerosol exposures.
The 2 editors and 35 chapter authors have put together, what might appear to be with only a superficial view, a text on biologic warfare materials. However, the chapter entitled “Bacillus anthracis: An aerobiological threat” is a specific example that there is more to the book than a treatise on bioweapons. The 51-page chapter with its 268 references has only 1 small section which is a single but lengthy paragraph entitled “Anthrax as a biological weapon.” Perhaps, the authors should have used the word “hazard” instead of “threat” in the chapter’s title. Not only do words have meaning, they also have nuances. Other chapters, to varying degrees, contain sections that lack a bioweapon focus. Chapter 8, “Detection of Airborne Pathogens and Toxins” is the analytical portal for the aerobiologist, bioweaponry notwithstanding.
The case that the book is not a bioweapons book has no better testament than the first chapter: “The Atmosphere: Its Development, History and Contribution to Microbial Evolution and Habitat.” This chapter could easily be the introduction section of cosmology-focused treatise on what is life and how did we get here or a scholarly work on the origin of life—where astrobiology meets aerobiology. If you favor philosophical leanings, then the chapter is just “a small step for a man, one giant leap for mankind” 8 in initiating that philosophical dialog with whomever will listen.
If you lack the interest or exploring where life came from, you will still cherish the first chapter because it makes a case for the distinction of the atmosphere as being a medium for bacteria versus being a vehicle for relocating microorganisms. If you are an atmosphere-as-a-vehicle toxicologist, then you will find, along with our epidemiology colleagues, “Chapter 14 Programing an Agent-Based Model for Disease Dynamics with Multiple Sources of Infection” interesting and one that has an application unrelated to bioweaponry while addressing the acute transmission of disease.
I found the Index to be the weakest aspect of the book. As an example from “Chapter 5 The Structural Biology and Biochemistry of the Ricin Toxin and the Military Use and Inhalation Toxicology of Ricin Aerosols,” specifically section “5.5 Signs, Symptoms and Toxicity of Ricin Exposure” discusses allergic reactions to ricin. Although the discussion centers around the allergic reaction caused by ricin that is IgE mediated, there is no entry in the Index for allergic (allergy), IgE, or immune. I became suspicious of the indexing problem when I realized that there were only 8 pages of index topics for 486 pages of text. As enigmatic as this may be, it is easily resolved by the reader with an electronic version of the book that can be subjected to a word search using an appropriate software.
This book is one that can easily be ignored because of its title. To do so would be a mistake because there are perspectives of toxicology that are offered which are not found in standard toxicology texts. It is not that subject matter is revolutionary but rather some often-addressed topics are done so in a fresh way in ATAPT. Toxicologists, no matter where they are going or from where they are coming, will find Aerobiology—The Toxicology of Airborne Pathogens and Toxins valuable and useful.
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