Occupational and environmental medicine: meeting the growing need for clinical services

The need for physicians trained in occupational and environmental medicine is addressed in this article, and strategies for recruiting such specialists are explored. Diseases caused or adversely affected by factors in the environment and workplace are expensive because of the direct and indirect costs, yet, in general, the issues of occupational and environmental disease are not sufficiently recognized. Traditionally in the US, occupational medicine has been the province of graduates of schools of public health; only recently has a clinical specialty in this area been established. Environmental medicine has barely come that far. Practitioners in these areas need to understand how to obtain information concerning occupational exposure and how to diagnose diseases that could result from such exposures. A partial list of these diseases, each associated with certain types of work, includes lung cancer, leukemia, asthma, chronic bronchitis, disorders of the nervous system, kidney failure, and high blood pressure. Specialists need to have broad training in several areas, such as toxicology, industrial hygiene, biostatistics, and epidemiology. As many as 5,500 physicians are needed in occupational and environmental medicine and recruiting them should be of highest priority. The basic approaches to recruitment should include increasing interest in the field; establishing centers where physicians can receive excellent training; integrating environmental medicine with occupational medicine; increasing funding for academic programs and faculty support; financing graduate training; and establishing methods of certification and accreditation of specialists in occupational and environmental medicine. Each of these goals is discussed in detail, with suggestions on how to accomplish them. (Consumer Summary produced by Reliance Medical Information, Inc.)