The occupational & environmental medicine clinic plays an important role in the growth and advance of occupational & environmental medicine.This study analyzes the disease distribution and referral routes of patients in an occupational & environmental medicine clinic of a university hospital.

843 Agent Orange cases and 839 other cases were treated in the clinic over a period of 4 years. The Agent Orange cases were excluded from this study. Distributions of age, sex, disease and referral route were examined according to the medical records of the hospital.

654 of the patients in the study population were male (77.9 %)and 185 were female (22.1 %).The most common age group consisted of patients in their forties.The number of cases has been increasing annually(1998,146 cases;1999,174 cases; 2000, 247 cases; 2001, 272 cases). The source of the cases were as follows: health examination, 548(65.4 %); health management service, 132(15.7 %);self-referral,125(14.9 %); physicians in other hospitals, clinics, 18 (2.1 %); and physicians in other clinic in the hospital, 16(1.9 %). The most commonly occurring disease was liver disease(28.6 %),followed by respiratory disease(12.8 %), gastroenteric disease (10.3 %)and musculoskeletal disease (8.7%).When the clinic was first opened, most cases came through 'health examination'. Subsequently the number of cases arising from 'self-refferal' and 'health management services' were increased.The disease distribution has also changed as the referral route distribution evolved.

In order to expand the work of the clinic, primary cares for patients who came from 'health examination' will be needed to settle down the clinic at the beginning. Thereafter,specialized services need to be developed for cases originating from 'self-refer-ral' and from referral by other organizations.Increasing the number of cases needs to go hand in hand with the development of good management skills.