Editorial: The Future of Environmental Medicine in Environmental Health Perspectives: Where Should We Be Headed?

This soon led to an expanded Environmental Medicine section that aimed to regularly publish articles in the Grand Rounds format as well as reviews, commentaries, case reports, and research articles, all of relevance to environmental medicine, with a focus mainly on clinical practice. The Grand Rounds series has been a resounding success, as reflected by the wide range of environmental medicine topics, the diversity of reporting sources, and the increased physician readership of the journal. Howard Hu served as the first Medical Editor from 1996 to 2004 and was then succeeded by Brian Schwartz; also in 2004, the journal appointed two Associate Medical Editors: Howard Hu and Gary Rischitelli. With this change in medical editorship, we wish to take the opportunity to present our views on the scope of the " environment " and " environmental medicine " and what we believe is the expanding nature of the field. We present this as a sounding board for ideas and not in any way as a definitive discussion of these issues. Our overall goal is to increase physician readership of the journal and engage EHP 's audience on a wide variety of environmental medicine topics relevant to both clinical and public health practice; this editorial is a first step in achieving this goal. We are in a changing world. The world's population continues to grow and the proportion of the elderly is increasing, with recognition of the susceptibility to health risks not only in early life but also in late life. The United States, once the greatest manufacturing nation in history, has become primarily a service economy. Many of the high-intensity hazardous exposures that were the traditional focus of early environmental and occupational health practitioners and social reformers are not the threat to large U.S. populations that they once were. Some exposures of concern remain as pockets of high-intensity hazards or as widespread chronic low-level hazards; new threats are being identified; and environmental factors and gene–environment interactions are thought to play a greater role in the etiology of many diseases than previously believed (Newton and Schwartz 2005; Schwartz 2005a, 2005b). We are quickly approaching a global economy, in which there is free movement of capital, goods, information, and services, if not free movement of labor. A great deal of manufacturing has shifted to developing countries, accompanied by levels of hazardous exposures not seen in the developed world in decades (LaDou 1994, …