The public ultimately provides money for medical research for one purpose only – to generate improvements in patient care [and public health] Medical researchers, editors, and peer reviewers should be under no illusions: the public does not support research for the pleasure of watching a cultural event If improved medical care [and improved public health] is not delivered, support for medical research . will dwindle and atrophy.

DF Horrobin1

In recent years it has been suggested that the multifaceted fields of occupational and environmental medicine are facing problems as disciplines. Jack Siemiatycki2 addressed several of the issues concerned when he focussed on the “future of occupational epidemiology” in a keynote speech at the 2007 EPICOH conference in Banff, Canada. One of his critical observations was that “over the past 20 years, occupational epidemiology has declined as regards its relative share of the epidemiological pie”. In a similar vein, it seems appropriate for some, if not many, of us to ask whether occupational and environmental medicine has lost its relative and due share of the “medical pie”.

While most representatives of our disciplines would agree that what we do is relevant for public health, there is increasing uneasiness as to whether our objectives and achievements are appropriately visible beyond our circles. Moreover, there is the disconcerting question of whether there is really consensus among, let alone beyond, ourselves as to what constitutes the important research issues lying ahead of us during the next, say, two decades on a global scale. And yet, it is very important to identify the challenges for occupational and environmental medicine and to ask ourselves why society should pay for our research for two main reasons:

• “Forewarned is forearmed”: in times of ever more limited resources, we need to be prepared to explain and, indeed, …