As much as I love ST:TMP and its designs, the worst thing that movie ever did was to set the precedent for putting the warp core smack dab in the middle of the engine room with people walking right by it. That's just plain crazy. A matter-antimatter reactor would generate immense heat and radiation. Realistically, it would have to go in an entirely separate module of the ship from the populated section, as far removed from it as practical. That's the whole reason Guzman and Jefferies gave the ship nacelles on struts in the first place -- because the engines were supposed to be separate from the populated portions of the ship.
At least TMP had the marginal sense to put its engineering crew in radiation suits, but realistically it would've been a blast furnace in there. Air conducts heat. You don't want an annihilation reactor sitting around in the same air that the crew is moving through and breathing.
Okay, so Trek tries to pay lip service to this with references to "coolant." But that coolant would have to be incredibly, even impossibly efficient to do its job under the depicted circumstances. Plus it's always depicted as toxic. So where's the sense in that design at all? Wouldn't it be so much simpler and safer to have the engines entirely outboard? To rely on distance and the insulation of vacuum to protect the crew from their heat and radiation?
And then there's the question of what happens to the heat after it's shunted away from the engines. There's some discussion of the problems of cooling a spacecraft in the "Why is the bridge on top?" thread from a few weeks ago, as I recall. Basically, cooling a spaceship is harder than most people assume because vacuum is a fine insulator. Overheating is a serious problem. You need large radiator surfaces, ideally fins extending perpendicular to the ship and able to radiate heat from both sides. The more surface area devoted to heat radiation, the better. Unfortunately, this is something that no fictional spacecraft design anywhere in film or television has ever acknowledged, as far as I'm aware.