[Epidemiology, social medicine, environmental medicine--a plea for a difficult but necessary integration]

The origins of environmental medicine date back more than 2000 years. The increasing incidence of environmental disease together with successful research into their etiology and pathogenesis have caused an impetus for this discipline in quantitative terms. A growing interest of patients, but also of politicians and parts of the industry in actual or suspected environmental risk factors for health have given rise to controversies--rendering the development of a rational, quality-oriented environmental medicine difficult, if not impossible. Given these controversies surrounding environmental health issues formal demarcations between the traditional disciplines (environmental) epidemiology, social medicine, occupational medicine, and environmental medicine become obsolete. Instead, a common agenda with respect to research, quality assurance, risk communication, and prevention as well as patient counselling and policy advising calls for a conceptual and institutional integration of these disciplines.