Modifiers (Noun Strings)
Modifiers (Noun Strings)
Although in English nouns can be used as modifiers, overuse of noun modifiers can lead to a lack of clarity. Purists may demand stricter rules on usage, but, as with the use of nouns as verbs (see 11.3, Correct and Preferred Usage, Back-formations), the process of linguistic change is inevitable, and grammatical rigor must be tempered by judgment and common sense.
Avoid |
Preferred |
|---|---|
diabetes patient |
patient with diabetes, diabetic patient |
depression episode |
depressive episode, episode of depression |
elderly over-the-counter drug users |
elderly users of over-the-counter drugs |
In The Careful Writer, Bernstein2 advises the use of no more than 2 polysyllabic noun modifiers per noun for the sake of clarity. However, long noun strings are sometimes difficult to avoid. If several of the attributive nouns are read as a unit, the use of more than 2 may not compromise clarity, especially in scientific or technical communications. Thus, noun strings may be more acceptable, for the sake of brevity, if the terms have been previously defined without noun strings. Some acceptable examples appear below:
community hospital program |
nicotine replacement program |
physician provider organization |
placebo pain medication |
risk factor surveillance system |
proficiency testing program |
baseline CD4 cell counts |
clinical research organization |
sudden infant death syndrome |
community outreach groups |
If there is a possibility of ambiguity, hyphens may be added for clarity (large-vessel dissection) (see Temporary Compounds in 8.3.1, Punctuation, Hyphens and Dashes, Hyphen).
