Environmental medicine: eight-year experience from the Outpatients' Unit of Environmental Medicine (UEM) at the University Hospital of Aachen

Between January 1988 and September 1996, a total of 682 patients were exami ned in the Outpatients' Unit of Environmental Medicine (UEM) at the Univers ity Hospital of Aachen, Germany. Most patients consulted the UEM because of unspecific health disorders, followed by questions about possible relation ships between an existing disease and environmental factors. Indoor polluti on with chemical substances were most frequently mentioned as suspected cau sative environmental factors. When an existing disease was documented, the patients' health complaints could often be interpreted as symptoms and sign s of this disease. Examinations carried out prior to consulting of the UEM differed greatly: some patients presented numerous results from different m edical disciplines, including comprehensive serological and immunological e xaminations. Usually the results of these examinations showed no or only mi nor deviations from the reference values with questionable medical relevanc e. On the other hand, in single cases basic medical diagnostics were ignore d. Thus, in several patients, iron deficiency anemia was diagnosed for the first time in the UEM and perfectly explained the patients' health complain ts. Relevant exposures to environmental factors could be confirmed by biolo gical or environmental monitoring in only 4.4% of the patients. In these ca ses, deviations from the reference values were mostly modest and of unclear clinical relevance.