THE clinical discipline of occupational medicine, largely unstudied, untaught, and unpracticed in major medical centers as recently as a decade ago, underwent unprecedented rejuvenation in the 1980s. Spurred by national regulatory programs and requirements, widespread litigation concerning toxic injury, and an altered public perception of environmental risks, the demand for the services of occupational medicine has risen sharply, especially outside the workplace.1 An outgrowth of this increase in demand has been an explosion of new investigations and new information as the field rejoins the mainstream of medicine, as well as new academic faculties, journals, and training programs.
The goal of this article is to describe and review some of the new knowledge about clinical occupational medicine. Given the breadth of the subject, we cannot discuss every important topic in occupational medicine; instead, we shall attempt to cover the areas most relevant to clinical practice, emphasizing those that tend to be ignored in the nonspecialized medical literature. In a few instances, we discuss major advances involving less common disorders, because of their conceptual importance to developments in the field as a whole.