The environmental medicine project Basel, Switzerland, counselled persons who related their health problems to environmental exposures. Complainants reported of symptom duration of several years (med. 3 yrs.) and having consulted physicians (69%) and/or alternative health care services (60%) beforehand. Participants in the project presented complex problems, investigations were very time consuming. To evaluate the benefit of the study, participants' individual project perception was assessed about half a year later.
All participants took part in medical and psychological-psychiatric examinations and were visited at home by the corresponding environmental agency. Results were discussed in a case conference and subsequently, counselling was offered. Finally, the project was evaluated, using telephone interviews. Participants were asked about changes in their health status, fulfilment of expectations in the project, whether they would recommend participation in such a study to others and about realisation of given advice and its effect. Each of these variables was tested with regard to age, sex, education and whether the team rated the suspected environmental exposure to be a plausible cause of the health complaints. SAMPLE: 63 persons completed the study, 54 (86%) could be interviewed for the evaluation. Mean age in the group was 54 years, 60% were female. In 40% of the cases the relationship between environmental exposure and at least one health problem was rated to be plausible by the project team.
Descriptive results of variables of satisfaction and compliance are given in the table below. Improvement of health status was negatively correlated to age and positively to environmental aetiology of health problems (LRT, both p = 0.01) as was the case with fulfilled expectations in the project (LRT, both p = 0.03). Successful implementation of given advice decreased with age (LRT p = 0.04) and was positively correlated with an environmental aetiology of the health problem (borderline, LRT p = 0.06). Recommendation of the project to others was correlated to none of the factors.
Environmental aetiology of health problem rated ‘plausible’ and age were predictors that determined satisfaction of the participants of our environmental medicine project. Other reasons to approve or disapprove of the project are more likely to be found on an individual level. Worsening of the health status might be an effect of older age. Approximately one third of the participants were able to benefit of the interdisciplinary project approach to improve long lasting health problems where support had been seeked in various health care settings beforehand.
(1) Institute For Social And Preventive Medicine, Basel, Switzerland
(2) Psychiatric University Hospital, Basel
(3) University Hospital, Basel
(4) State Laboratry Basel-City
(5) Faculty of Law, University of Basel
(6) Swiss Federal Office of Public Health, Bern
(7) Agency for Environmental Protection and Energy, Liestal