Environmental health response clinics. A survey of program options

Environmental Health Response Clinics are established in response to concerns about community exposures to hazardous situations (chemical, biological, radiological). They are developed in response to a demand for "clinical services" and operate outside the usual health care financing and delivery mechanisms. Prompted by their experience in California, the authors formed a focus group to identify possible goals and services. A mail survey of occupational-environmental health professionals was then conducted to evaluate the feasibility and priority of representative goals. The analysis suggests that services should focus on the specific hazard of concern and that communication and education are essential components. The tendency to "do a general physical examination" should be eschewed. Ratings for priority and feasibility were disparate for several possible goals. In some instances, a "hands-on examination" may not be the best use of resources. Environmental health professionals may serve by direct clinical service or by advising community-based practitioners. Providing routine clinical services alone cannot meet the expectations for an environmental health response clinic.