The practice of environmental medicine requires the knowledge to identify, understand and treat health problems that arise from the interaction between people and the environment. This can occur via immune or non-immune system pathways. Consider the fact that during the last century, a large number of chemicals have accumulated in air, food and water, and humans sit on top of the food chain while breathing polluted air, both outdoors and indoors. Although small exposures may seem insignificant and harmless, some chemical agents accumulate within the human body and have the potential to eventually reach levels where clinical illness could ensue. There is potential for both additive and synergistic effects. Cumulative exposure from various sources has resulted in the Centers for Disease Control finding that the average American child and adult have accumulated numerous toxicants in their bodies. Chemical compounds can adversely affect cells and tissues through several differing mechanisms. In addition to causing direct cellular damage to cell membranes or various intracellular components, numerous studies reveal that xenobiotics (foreign chemicals) can also alter communication between cells and thus disrupt cellular and tissue regulation.

There is also a significant amount of evidence for an adverse impact of environmental chemicals on immune system function and the pathogenesis of immune diseases, such as allergy and asthma. Exposure to pollutants has also been associated with many other adverse human health effects, including impaired neurodevelopment and reproductive function, neurodegenerative disorders, pulmonary and cardiovascular diseases, and diabetes.

The first environmental physicians were the allergists at the turn of the last century, who described people who reacted adversely to pollens etc. In the 1970's, negative effects from chemical exposures, including cognitive complaints, were being described in the medical literature. In the 1980's, the World Health Organization began to describe and categorize these patients, according to the severity of symptoms in the central nervous system.

Because of the energy crisis in the 70's, new and existing buildings were more insulated and mechanically ventilated, using cheaper materials, which tend to off-gas chemical pollutants, resulting in the development of Sick Building Syndrome, first described by the World Health Organization in 1984.

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