There is now no longer any doubt among most medical investigators that air pollution is a medical problem in terms of the millions of persons exposed, the subtlety and variety of its effects, and its tendency to worsen with increasing urbanization.
Specific etiological manifestations of air pollution are presently beyond routine methods of clinical detection and management, except in accidental exposures to high concentrations or disaster episodes. It is obvious, however, that patients can no longer be treated apart from their environment. Even in his practice, the physician must take into account the possible effects of air pollution: Is air pollution aggravating illness? Under what conditions should a patient with a critical respiratory ailment be advised to move to another location? To what location?
In making such decisions, the physician must interpret both endogenous and exogenous factors— the patient and the environment in which he lives. The physician should be