[Development of minimal requirements for site assessment and monitoring to estimate exposure in environmental medicine--the Hamburg approach].

As a further step towards quality management in environmental medicine the Hamburg Association of Panel Physicians and the Hamburg Department of Labour, Health and Welfare developed a consensus paper concerning the handling of indoor related problems. It focuses on the cooperation between environmental physicians and engineers. A critical point in the process of environmental health risk assessment is the selection of either human biomonitoring or environmental monitoring. Further well-known problems are quality of measures and process documentation. Accurate, reliable measures of individual exposure are an essential need for physicians who have to judge the potential impact of environmental contaminants on human health. The approach proposed in this paper was chosen to enable the patient and the physician to benefit from the special knowledge of environmental engineers on indoor related problems. The procedure and criteria might help to reduce misclassifications of diseases and the amount of measures with no medical relevance and to establish scientifically valid associations between health outcomes and exposures to environmental contaminants.