Textbook of Clinical Occupational and Environmental Medicine. Rosenstock L, Cullen MR, eds., Philadelphia, PA: W.B. Saunders Company, 1994 Jul; :1-21
Occupational and environmental medicine (OEM) is an emerging clinical specialty that seeks to identify and modify the adverse effects of the workplace and nonoccupational environment on the health of individuals or populations. The focus of OEM differs from that of many specialties, which may encompass interest in particular agents (e.g., infectious disease), organ systems (e.g., pulmonary medicine), or mechanisms of injury (e.g., immunology). In traditional clinical evaluation and treatment, the focus of attention is on factors that the patient or clinician, or both, can modify. In OEM practice, although the individual patient is also of primary importance, there is a need to attend to external factors that are distinctly beyond the direct control of patient or physician. Further, these same external factors affecting one patient may threaten the health of others. There is commonly a natural tension between the clinical health issues relating to the individual patient and broader public health issues, which transcend the traditional doctor-patient relationship. Another dimension that distinguishes OEM practice is the extent to which social and economic factors dominate both clinical practice and related public health concerns. At the individual level, virtually no question about environmental or occupational health can be raised or answered without consideration of the impact on major personal issues, including the patient's work, income, or home life. Similarly, public health actions related to the identification of a toxic exposure at a workplace or in a community are complicated by economic and legal ramifications. In this chapter, some of the core principles of OEM practice are explored that distinguish it from those aspects of clinical medicine with which the reader may be familiar. We will discuss the fundamentals of both individual health and related public health aspects of practice.
Occupational-medicine; Environmental-medicine; Environmental-health; Occupational-health; Sociological-factors; Work-environment; Worker-health; Exposure-assessment; Dose-response; Environmental-exposure; Occupational-exposure; Biological-effects; Diagnostic-tests; Epidemiology; Screening-programs; Medical-screening