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Umweltmedizinische Aspekte bei Patienten einer Facharztpraxis für Allgemeinmedizin

Background: Little is known about the frequency and kind of environment-related health disorders in patients of general practitioners. Study Aim: In the present study, the kind and frequency of environment-related health disorders was to be assessed with a standardized questionnaire in patients of a general practitioner without experience in environmental medicine and independent of the physician consulted. Patients and Methods: Every patient who consulted a selected general practitioner for the first time between July and September 2003 was asked to fill in a standardized environmental health questionnaire. Results: Of the about 900 patients who attended the general practitioner practice during the study period, 489 patients agreed to fill in the questionnaire and 275 of these returned the forms (144 men, 131 women; average age: 46.7 ± 19.4 years). Of these, 86 were smokers, 57 ex-smokers, and 101 never smokers (no data: 31). The most frequently indicated diseases were allergies (n = 243), metabolic diseases (n = 176), musculoskeletal disorders (n = 156) and cardiocirculatory diseases (n = 145). Unspecific symptoms of the musculoskeletal system (n = 65), the cardiocirculatory system (n = 37) and the respiratory system (n = 28) predominated. 55 patients suspected micro-organisms (n = 34), physical factors (n = 27) and/or harmful substances (n = 11) as possible causes of their symptoms, 23 of these also suspected mental factors as a concomitant cause. Typical exposures at home were renovations during the previous five years (195 patients), damp walls (26 patients) and current exposure to mould (13 patients). The main exposure factors at the workplace were heat (n = 39), cold (n = 36), noise (n = 27) and dust (n = 27) as well as contact with solvents (n = 37) and plastics (n = 34). Conclusions: Identified were heterogeneous exposure factors at home and at the workplace which only few patients blamed for their health problems. Basic knowledge of environmental and occupational medicine is needed for a correct assessment of the health relevance of these various exposures, independent of whether or not the patients consider their health disorders to be related to the exposures. These fields should be included in the education of every general practitioner. In this way, primary care in these fields of medicine could be improved.