Pii: S0003-4878(99)00089-7

`Occupational hygiene in developing countries' has been on the agenda of conferences, symposia and scienti®c journals for more than two decades. The earliest reference I could trace in MEDLINE under this key term stems from a conference in East Germany (Elling, 1978) and the latest was the 1996 William P. Yant award lecture by Bernice Goelzer (Goelzer, 1996). Despite this, a look at recent volumes of occupational hygiene journals reveals few papers from developing countries, and the majority of these come from the fast-developing economics of East Asia. There are very few from the low-income countries of Latin America and Africa. The paper presented by Ohayo-Mitoko et al. from Kenya in this issue seems to be the ®rst paper from Africa (outside South Africa) in the Annals for a long time (Ohayo-Mitoko et al., 1999). Of course, the number of publications in leading occupational hygiene journals cannot equate to the state of occupational hygiene in a country. Lack of a publishing tradition and the language barrier will also play a role, but the results of this quick literature review are worrying given the fact that the majority of workers in our world are from low-income countries. These workers are increasingly exposed to hazardous situations which no longer exist in the western world. In addition hazardous industries and chemicals are quite often wilfully exported to these low-income countries. Besides, poor socio-economic and meteorological conditions will often intensify the occupational health risks. Several publications have pointed out that skilled occupational hygiene professionals are lacking in most low-income countries (Loewenson, 1995; Goelzer, 1996) and that only occupational physicians provide some of the necessary health care. So, why are we in a situation that at workplaces where occupational hygiene is apparently most needed, it seems to be absent? First, it could be that the importance of occupational hygiene has not been clearly enough demonstrated to make it a structural discipline within the ®eld of occupational health in developing countries. As such, the situation is not di€erent from how it was in my own country, the Netherlands, twenty years ago. It took a meeting of occupational physicians in 1978 to start the ®rst MSc course in occupational hygiene in Wageningen (Tordoir, 1978). Since then, more than two hundred students have graduated and the majority have joined occupational health units. Nowadays, occupational hygiene has established a ®rm base in The Netherlands. So apparently, with consensus about the role of occupational hygiene in occupational health and an established legal status, something lasting can be established. Unfortunately, in lowincome countries it is doubtful whether consensus exists even about the importance of occupational health. Second, it could be that occupational hygiene in these countries needs di€erent priorities, and it is wrong to export the methods and training of developed countries. The work in developing countries should emphasise interventions, i.e. substitution and elimination of hazardous technologies rather than extensive exposure surveys. It should also focus more on the non-formal sector where a large proportion of workers is employed. High-tech sophisticated tools and strategies are most of the time not needed. Curricula for occupational hygiene in developing countries should therefore be di€erent from our regular curricula. Specialised courses should be o€ered on location, rather than having trainees from developing countries following regular education in the developed world. The latter merely serves academic institutions that are being confronted with dwindling numbers of students. Sandwich courses where the student does the Ann. occup. Hyg., Vol. 43, No. 8, pp. 501±503, 1999 # 1999 British Occupational Hygiene Society Published by Elsevier Science Ltd. All rights reserved Printed in Great Britain. 0003±4878/99/$20.00