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People are increasingly concerned about potential environmental health hazards and often ask their physicians questions such as: "Is the tap water safe to drink?" "Is it safe to live near power lines?" Unfortunately, physicians often lack the information and training related to environmental health risks needed to answer such questions. This book discusses six competency based learning objectives for all medical school students, discusses the relevance of environmental health to specific courses and clerkships, and demonstrates how to integrate environmental health into the curriculum through published case studies, some of which are included in one of the book's three appendices. Also included is a guide on where to obtain additional information for treatment, referral, and follow-up for diseases with possible environmental and/or occupational origins.

Suggested Citation

Institute of Medicine. 1995. Environmental Medicine: Integrating a Missing Element into Medical Education. Washington, DC: The National Academies Press.

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Publication Info

992 pages |  8.5 x 11 | 

  • Hardcover:  978-0-309-05140-8
  • Ebook:  978-0-309-17674-3
Chapters skim
Front Matter i-xii
Executive Summary 1-4
1 Introduction 5-13
2 Curriculum Content 14-21
3 Implementation Strategies 22-43
4 Changing Medical Education 44-51
5 Concluding Remarks 52-53
References 54-58
Appendixes 59-60
A: Taking an Exposure History 61-96
B: Medical School Courses and Clerkships: Access Points for Integrating Environmental Medicine 97-120
C: Case Studies in Environmental Medicine 121-138
Case Study 1: Arsenic Toxicity 139-163
Case Study 2: Seasonal Arsenic Exposure from Burning Chromium-Copper-Arsenate-Treated Wood 164-167
Case Study 3: Asbestos Toxicity 168-188
Case Study 4: Benzene Toxicity 189-207
Case Study 5: Beryllium Toxicity 208-223
Case Study 6: Cadmium Toxicity 224-243
Case Study 7: Fetal Death Due to Nonlethal Maternal Carbon Monoxide Poisoning 244-248
Case Study 8: Carbon Tetrachloride Toxicity 249-266
Case Study 9: Chlordane Toxicity 267-288
Case Study 10: Chronic Reactive Airway Disease Following Acute Chlorine Gas Exposure in an Asymptomatic Atopic Patient 289-290
Case Study 11: Chromium Toxicity 291-311
Case Study 12: Cyanide Toxicity 312-331
Case Study 13: Dioxin Toxicity 332-348
Case Study 14: Ethylene/Propylene Glycol Toxicity 349-371
Case Study 15: Formalin Asthma in Hospital Staff 372-373
Case Study 16: Gasoline Toxicity 374-394
Case Study 17: Hantavirus Pulmonary Syndrome: A Clinical Description of 17 Patients with a Newly Recognized Disease 395-401
Case Study 18: Lead Poisoning from Mobilization of Bone Stores During Thyrotoxicosis 402-409
Case Study 19: Lead Toxicity 410-435
Case Study 20: Legionaires' Disease: Description of an Epidemic of Pneumonia 436-444
Case Study 21: Mercury in House Paint as a Cause of Acrodynia: Effect of Therapy with N-Acetyl-D, L-Penixillamine 445-449
Case Study 22: Mercury Toxicity 450-472
Case Study 23: Methanol Toxicity 473-492
Case Study 24: Methylene Chloride Toxicity 493-511
Case Study 25: Paint Remover Hazard 512-515
Case Study 26: Fatal Outcome of Methemoglobinemia in an Infant 516-517
Case Study 27: Nitrate/Nitrite Toxicity 518-537
Case Study 28: An Outbreak of Nitrogen Dioxide-Induced Respiratory Illness Among Ice Hockey Players 538-541
Case Study 29: Pentachlorophenol Toxicity 542-557
Case Study 30: Aldicarb Poisoning: A Case Report with Prolonged Cholinesterase Inhibition and Improvement After Pralidoxime Therapy 558-561
Case Study 31: Cholinesterase-Inhibiting Pesticide Toxicity 562-584
Case Study 32: Infertility in Male Pesticide Workers 585-587
Case Study 33: Pesticide Food Poisoning from Contaminated Watermelons in California, 1985 588-595
Case Study 34: Poisoning of an Urban Family Due to Misapplication of Household Organophosphate and Carbamate Pesticides 596-604
Case Study 35: Polynuclear Aromatic Hydrocarbon (PAH) Toxicity 605-621
Case Study 36: Polychlorinated Biphenyl (PCB) Toxicity 622-638
Case Study 37: Ionizing Radiation 639-673
Case Study 38: Radon Toxicity 674-694
Case Study 39: Residential Radon Exposure and Lung Cancer in Sweden 695-700
Case Study 40: Community Oubreaks of Asthma Associated with Inhalation of Soybean Dust 701-706
Case Study 41: Tetrachloroethylene Toxicity 707-726
Case Study 42: Toluene Toxicity 727-743
Case Study 43: Occupational Asthma Due to Toluene Diisocyanate Among Velcro-like Tape Manufacturers 744-749
Case Study 44: 1,1,1-Trichloroethane 750-766
Case Study 45: Trimethyltin Encephalopathy 767-771
Case Study 46: Trichloroethylene Toxicity 772-792
Case Study 47: Vinyl Chloride Toxicity 793-811
Case Study 48: Work-Related Disorders of the Neck and Upper Extremity 812-813
Case Study 49: Contact Dermatitis in Surgeons from Methylmethacrylate Bone Cement 814-816
Case Study 50: Skin Lesions and Environmental Exposures: Rash Decisions 817-861
Case Study 51: Acoustic Trauma Caused by the Telephone: A Report of Two Cases 862-867
Case Study 52: Behavioral and Audiologic Manifestations of Noise-Induced Hearing Loss 868-871
Case Study 53: Reproductive and Developmental Hazards 872-892
Case Study 54: Childhood Asthma and Indoor Enviromental Risk Factors 893-903
Case Study 55: Populations at Risk From Particulate Air Pollution - United States, 1992 904-908
D: Resources: Agencies, Organizations, Services, REferences, and Tables of Environmental Health Hazards 909-970
E: Committee and Staff Biographies 971-975

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