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Laryngorhinootologie 2000; 79(2): 100-127
DOI: 10.1055/s-2000-8793
ÜBERSICHT
Georg Thieme Verlag Stuttgart ·New York

Umweltmedizin in der HNO-Heilkunde

Environmental Health in Otorhinolaryngology H. Riechelmann
  • Univ. HNO-Klinik Ulm (Ärztlicher Direktor: Prof. G. Rettinger)
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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung

Hintergrund: Krankheiten entstehen aus inneren, genetisch determinierten Ursachen und infolge äußerer, aus der Umwelt auf das Individuum einwirkender Faktoren. Aus der Vielfalt gesundheitsrelevanter Umweltfaktoren geht es der Umweltmedizin um durch menschliches Handeln entstandene physikalische und chemische Faktoren. Der gegenwärtige Wissensstand über die Bedeutung solcher Faktoren für die Entstehung von Erkrankungen der Kopf-Hals-Region soll zusammengestellt werden. Methoden: Daten aus Lehrbüchern, Übersichtsarbeiten und Originalarbeiten, aus Recherchen in medizinischen Literaturdatenbanken, Internet-Recherchen, sowie aus Veröffentlichungen deutscher, amerikanischer und internationaler Behörden sowie umweltmedizinisch tätiger Organisationen wurden zusammengetragen, geordnet, kritisch gewertet und zusammengefasst dargestellt. Ergebnisse: Die Organsysteme der Kopf-Hals-Region sind besonders häufig von umweltbedingten Erkrankungen betroffen. Umweltmedizinisch relevant sind Geruchsbelästigungen und Störungen des Riechsinnes, Reizzustände und Schäden der Atemwegsschleimhaut, entzündliche und allergische Erkrankungen der oberen Atemwege und des Mittelohres, Erkrankungen von Kehlkopf und Stimme, Tumoren der Kopf-Hals-Region, aurale und extraaurale Schäden durch Freizeit- und Umweltlärm sowie Hör- und Gleichgewichtsstörungen durch chemische Umweltschadstoffe. Schlussfolgerung: Die komplexe Anatomie, Physiologie, Funktions- und Differenzialdiagnostik erfordert unabdingbar die Sachkenntnis und Erfahrung des Hals-Nasen-Ohrenarztes bei der Erfassung und Bewertung umweltbedingter Krankheitszustände von Organsystemen der Kopf-Hals-Region. Andererseits gehört die Umweltmedizin wie die Arbeitsmedizin eher zur Präventivmedizin als zur kurativen Medizin. Dies bedeutet, dass beim umweltmedizinisch tätigen Hals-Nasen-Ohrenarzt neben Kenntnissen toxikologischer Eigenschaften wichtiger Umweltschadstoffe auch Verständnis für epidemiologische Verfahren und Begriffe vorhanden sein muss. Fortschritte auf dem Gebiet der Umweltmedizin in der HNO-Heilkunde werden durch die naturwissenschaftlich fundierte Zusammenarbeit von Epidemiologen, Arbeitsmedizinern, Umwelttoxikologen und Hals-Nasen-Ohrenärzten erzielt.

Background: Genetic and environmental factors contribute to the development of human diseases. This review article deals with the impact of physical and chemical environmental pollutants on the development of various diseases in otorhinolaryngology. Methods: Data were obtained from textbooks, review articles, original publications, medical databases, internet searches, and publications of various German and international agencies and organizations concerned with environmental health. Results: Environmental pollutants are important contributing factors in the etiology of head and neck diseases. Health effects include hearing loss due to noisy leisure time activities and cardiovascular diseases due to traffic noise, impairment of hearing and equilibrium induced by various compounds, odor annoyance and olfactory disturbances, irritation and alterations of respiratory mucosa, acute and chronic inflammatory and allergic diseases of the upper airways and the middle ear, disorders of the voice and larynx, and head and neck tumors. Conclusion: Environmental medicine may play an increasingly important role in the prevention of head and neck diseases. It requires a considerable toxicological and epidemiological qualification. However, the contribution of specialists well familiar with the complex anatomy, physiology and functional diagnosis of organ systems located in the head and neck are essential for the reliable assessment of environmental diseases in otorhinolaryngology.

Schlüsselwörter:

Umweltmedizin - Umweltschadstoffe - Freizeitlärm - Schwindelerkrankungen - Rhinitis - Sinusitis - Laryngitis - Kopf-Hals-Tumoren

Key words:

Environment - Hearing loss - Vertigo - Sinusitis - Otitis media - Laryngitis - Head and neck tumors

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