Travel Medicine and Infectious Disease (2011) 9, 221e222

available at www.sciencedirect.com

journal homepage: www.elsevierhealth.com/journals/tmid

BOOK REVIEW
L. Murray, F. Daly, M. Little, M. Cadogan, Toxicology
Handbook, xii 529 pp, paperback with illustrations,
2nd ed. Imprint of Elsevier, Sydney, Churchill Livingstone,
2007, ISBN 978-0-7295-3939-5, RRP: $69.95.
The Hazardous Substance Data Bank of the National Library
of Medicine in the United States contains information on
more than 5000 hazardous chemicals.1 In Australia alone,
there were over 799 deaths due to accidental poisoning in
2009.2 Clinicians are confronted with a formidable task in
evaluating and resuscitating poisoned patients daily,
sometimes under life-threatening circumstances. The
availability today of a number of toxicology reference
publications has assisted greatly; including a book published by Australian physicians. The Toxicology Handbook,
now in its 2nd edition, is establishing itself as one of the
leading reference manuals in the field of toxicology.
The 2nd edition of the Toxicology Handbook is presented
as a 529-page A5 publication that would fit easily into the
briefcase or carry bag. In addition to the no nonsense,
three-colour, semi-glossy cover, the contents of the Toxicology Handbook continue this theme. It also contains
a table of Contents, a Foreword by Professor Anthony FT
Brown-Editor-in-Chief of Emergency Medicine Australasia,
a Preface, a list of Authors, a list of Contributors, a list of
Reviewers, six chapters, 166 sections, seven Appendices,
and a comprehensive Index. There is no bibliography,
glossary, acknowledgements or list of abbreviations. It is
now part of the Student Consult series and has searchable full text online, which is activated via PIN provided in
the inside cover of the manual.
The primary target audience of the 2nd edition of the
Toxicology Handbook is stated to be hospital-based
doctors at all levels. It is also mentioned that it would also
be a useful resource for ambulance service paramedics and
pharmacists. Although not mentioned, the manual would
also be a useful resource for general practice and travel
clinics, as well as specialist medical trainees and postgraduate students needing to have some grasp of
toxicology.
The Chapters include Chapter 1: Approach to the
poisoned patient; Chapter 2: Specific considerations;
Chapter 3: Specific Toxins; Chapter 4: Antidotes;
Chapter 5: Envenomings; and Chapter 6: Antivenoms.
By far the largest section at 240 pages is Chapter 3, which
discusses 78 toxins from Alcohol to Warfarin. The

doi:10.1016/j.tmaid.2011.08.001

description of the toxins includes very useful handy tips,

Pitfalls, and Controversies. The inclusion of Envenomings and Antivenoms is very useful from the Australian
perspective, but includes some broader discussion of
envenomings, which could be considered a limitation of
these sections, except that the handbook is directed
primarily at the Australian market. There are six Appendices titled Poisonings Information Telephone Numbers,
Example ECGs, Conversion factors and therapeutic
ranges for important toxins, Alcohol Pathways, Therapeutic Over-warfarinisation, and Management of
Allergic Reactions to Antivenoms.
Details of the four authors are given on the back cover as
well as on page xi and they are well known in Australasia.
Lindsay Murray is Consultant Emergency Physician and
Clinical Toxicologist, Sir Charles Gairdner Hospital, Perth
Australia. Frank Daly is Director of Emergency Department
and Consultant Clinical Toxicologist, Royal Perth Hospital,
Perth, Australia. Mark Little is Consultant Emergency
Physician and Clinical Toxicologist, Royal Perth Hospital,
Perth, Australia. Mike Cadogan is Consultant Emergency
Physician, Sir Charles Gairdner Emergency Department,
Perth, Australia.
The consistent and concise style ensures that the 2nd
edition of the Toxicology Handbook is easy to read. Given
that this is only the 2nd edition of the Toxicology Handbook, it is a remarkably mature reference manual, which is
a credit to the authors and contributors. The Toxicology
Handbook has little competition nationally and only some
competition internationally. A useful companion to the 2nd
edition of the Toxicology Handbook would be the Therapeutic Guidelines-Toxicology and Wilderness.3 The 2nd
edition of Toxicology Handbook will certainly appeal to
specialists and trainees in emergency medicine and other
hospital doctors in Australasia, particularly those who do
not already use a similar guide or those who wish to include
a local work in their reference portfolio. The cost is not
prohibitive for clinicians and other health staff, and the 2nd
edition of the Toxicology Handbook is rapidly becoming an
important addition to the exclusive international portfolio
of standard manuals and textbooks in the area of
toxicology.

Ethical approval
None.

222

Funding
None.

Conflict of interest statement

None.

References
1. National Library of Medicine, TOXNET. Hazardous substances
data bank. URL. http://toxnet.nlm.nih.gov/cgi-bin/sis/
htmlgen?HSDB (accessed 2 August 2011).
2. Australian Bureau of Statistics. External causes. Released 3 May
2011. Catalogue No. 3303.0. In: Causes of death Australia, http://

Book review
abs.gov.au/AUSSTATS/abs@.nsf/mf/3303.0/; 2009 (accessed 2
August 2011).
3. Emergency Medicine Expert Group. Therapeutic guidelines:
toxicology and wilderness. 1st ed. Melbourne: Therapeutic
Guidelines Limited; 2008. Reviewed Travel Med Inf Dis 2009; 7:
175e176.

Peter A. Leggat
School of Public Health,
Tropical Medicine and Rehabilitation Sciences,
James Cook University, Townsville,
Queensland 4811, Australia
E-mail address: peter.leggat@jcu.edu.au
16 August 2011
Available online 1 September 2011