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Your Environment. Your Health.

2014

Paul English, Ph.D. – Addressing the Impacts of Air Pollution, Pesticides, and Climate Change

December 18, 2014

Paul English
Paul English, Ph.D. (Photo courtesy of Public Health Institute)

As an environmental epidemiologist, Paul English, Ph.D. is taking a proactive approach to addressing health disparities. Over the last ten years, he has served as principal investigator of the California Environmental Health Tracking Program (CEHTP), which takes a community-based approach to developing surveillance and biomonitoring systems for environmental hazards. Specifically, his work focuses on the public health impacts of climate change, environmental links to asthma, and the impacts of pesticides on birth outcomes.

“The core issue is really about fairness and justice,” says English, when speaking of his work at the California Department of Public Health (CDPH). To achieve equity, English seeks to address problems related to both income disparities and health disparities, which he believes run parallel.

“In California, we have this dichotomy of the well-off people living on the coast, and we have all these poorer and more vulnerable populations [living inland in farm country], and they’re getting the brunt of the pollution,” says English. “So, we’re seeing all kinds of environmental justice issues at play.” Vulnerable, low-income populations tend to live inland, where they are exposed to contaminated air, in part, from the air migration of pollutants coming from more affluent areas.

While working on a broad array of environmental health topics, English’s work in Imperial County, California, near the U.S.-Mexico Border, has been particularly important for addressing local environmental health disparities. This low-income, primarily Latino community has one of the highest rates of asthma hospitalization and emergency room visits in the state – outcomes that have been linked to the region’s poor air quality.

The project has been effective at understanding and addressing the region’s high asthma rates by (1) using community expertise to inform the placement of low-cost air quality monitors, (2) using novel methods to combine data from the low-cost monitors with existing data sources in order to create high-resolution maps of air pollution and real-time maps of pollution “hot spots,” and (3) enhancing a community-initiated online mapping tool with air quality data from the monitors.

English’s other projects emphasize “research for action.” For instance, the CEHTP published a seminal report, Agricultural Pesticide Use near Public Schools in California, documenting that pesticides of public health concern were applied within a quarter mile of one-third of public schools in California’s agricultural region. Hispanic children were nearly 50% more likely, as compared with white children, to attend schools where pesticides of public health concern were measured. English used these findings to make evidence-based recommendations to state agencies and other stakeholders on how to improve data to reduce agricultural pesticide use near public schools.

What is English’s vision for the future of his research? “I hope to continue accomplishing work on air quality, pesticides, and other issues of concern by taking this community-based approach to provide citizens with the capacity to take action independently – whether it’s getting the help they need or seeking training,” he says. In his view, community involvement will establish a sustainable approach to addressing California’s most pressing public health concerns.

English acknowledges that the work of his program would not be possible without his great team, which includes experts in medicine, statistics, information technology and geographic information systems, health education/communication, and program management.

Highlighted Publications

  • Carmichael SL, Yang W, Roberts E, Kegley SE, Padula AM, English PB, Lammer EJ, Shaw GM. 2014. Residential agricultural pesticide exposures and risk of selected congenital heart defects among offspring in the San Joaquin Valley of California. Environ Res 135:133-138. [Abstract]
  • Shaw GM, Yang W, Roberts E, Kegley SE, Padula A, English PB, Carmichael SL. 2014. Early pregnancy agricultural pesticide exposures and risk of gastroschisis among offspring in the San Joaquin Valley of California. Birth Defects Res A Clin Mol Teratol 100(9):686-694. [Abstract]
  • Yang W, Carmichael SL, Roberts EM, Kegley SE, Padula AM, English PB, Shaw GM. 2014. Residential agricultural pesticide exposures and risk of neural tube defects and orofacial clefts among offspring in the San Joaquin Valley of California. Am J Epidemiol 179(6):740-748. [Abstract]
  • Carmichael SL, Yang W, Roberts EM, Kegley SE, Wolff C, Guo L, Lammer EJ, English P, Shaw GM. 2013. Hypospadias and residential proximity to pesticide applications. Pediatrics 132(5):e1216-1226. [Abstract]
  • Roberts EM, English PB. 2013. Bayesian modeling of time-dependent vulnerability to environmental hazards: an example using autism and pesticide data. Stat Med 32(13):2308-2319. [Abstract]
  • Reid CE, Mann JK, Alfasso R, English PB, King GC, Lincoln RA, Margolis HG, Rubado DJ, Sabato JE, West NL, Woods B, Navarro KM, Balmes JR. 2012. Evaluation of a heat vulnerability index on abnormally hot days: an environmental public health tracking study. Environ Health Perspect 120(5):715-720. [Abstract]
  • Richardson MJ, English P, Rudolph L. 2012. A health impact assessment of California’s proposed cap-and-trade regulations. Am J Public Health 102(9):e52-58. [Abstract]
  • English P, Blount B, Wong M, Copan L, Olmedo L, Patton S, Haas R, Atencio R, Xu J, Valentin-Blasini L. 2011. Direct measurement of perchlorate exposure biomarkers in a highly exposed population: a pilot study. PLoS One 6(3):e17015. [Abstract]
  • English PB, Sinclair AH, Ross Z, Anderson H, Boothe V, Davis C, Ebi K, Kagey B, Malecki K, Shultz R, Simms E. 2009. Environmental health indicators of climate change for the United States: findings from the State Environmental Health Indicator Collaborative. Environ Health Perspect 117(11):1673-1681. [Abstract]

Anna Goodman Hoover, Ph.D. - Taking Time to Dialogue with Stakeholders

Anna Goodman Hoover
“We need to work closely with people, not just to understand and respect their values but to support their efforts to make informed, evidence-based environmental health decisions that also incorporate those values.” - Anna Hoover, Ph.D.
(Photo courtesy of the University of Kentucky)

December 10, 2014

Anna Hoover, Ph.D., knew she wanted to go into science communication early in life. “When I was a kid, I wanted to be Carl Sagan. He was so good at talking about complicated scientific concepts to normal people like me,” she explained. After working in radio and studying theatre, history, and communication, she eventually found her home in the field of research translation.

She earned a Ph.D. in Communication Science in 2013 from the University of Kentucky, where she now serves as Communications Director and Research Translation Core (RTC) co-lead for the University of Kentucky Superfund Research Center (UK-SRC). Her role in the RTC often involves working with people from many university departments to ensure that everyone’s information needs – including those of community and government stakeholders – are met, all the while trying to minimize the amount of jargon or alphabet soup in the final product.

Hoover is also deputy director for the National Coordinating Center for Public Health Services and Systems Research, a Robert Wood Johnson Foundation national program office. In this capacity, she provides scientific leadership and develops dissemination and research translation efforts for a portfolio of more than 120 extramural research projects while also supporting more than 30 academic-practitioner research networks across the country. “My role with the Coordinating Center complements my Superfund communication efforts by connecting directly to public health and policy stakeholders, helping ensure that these constituencies play important roles both in setting our environmental health research priorities and as potential research end users,” said Hoover. This position includes a research faculty appointment in the UK College of Public Health, where she studies stakeholder engagement processes, participatory risk communication, and the dissemination and implementation of evidence-based public health strategies.

Some key projects that Hoover has been involved with to date include:

The Future Vision for the Paducah Gaseous Diffusion Plant (PGDP) – funded by the U.S. Department of Energy

To create a publicly-approved future vision for the PGDP National Priorities List Superfund site, Hoover worked with a multidisciplinary team, facilitating interviews and focus groups designed to identify and address stakeholder needs. The research team, which included scientists from the Kentucky Research Consortium for Energy and the Environment, the Kentucky Water Resources Research Institute, the UK College of Communication and Information, and the Kentucky Transportation Center, developed a protocol steeped in community-based participatory communication methodologies. It also incorporated key elements of Structured Public Involvement, including the Arnstein Ladder as a stakeholder engagement evaluation metric. Hoover described this methodological approach in detail during a presentation available through the US Environmental Protection Agency’s (EPA) CLU-IN archive. Findings are available in the final project report. The UK-SRC RTC is now investigating ways to modify the protocol to fit the needs of other Superfund communities.

The Research Translation Seminar Series – jointly sponsored by UK-SRC and the Kentucky Department for Environmental Protection

Hoover, RTC director Lindell Ormsbee, Ph.D., and other program staff have worked closely with state government stakeholders to identify their information needs regarding Superfund-related issues. The UK-SRC RTC ensures these needs are met by arranging bimonthly presentations in the state capital that feature subject matter experts from within and outside UK-SRC.

Nutrition Brochures – produced by UK-SRC

Hoover worked closely with the UK-SRC Community Engagement Core and the university’s Cooperative Extension Service to create two brochures detailing ways to offset environmental exposures with healthy food choices. One brochure is written for a lay audience, and the other brochure provides more detail for audiences who have stronger backgrounds in nutrition and environmental science.

What’s next for Hoover?

Hoover’s most recent work focuses on ensuring communities and decision makers have the information they need to stay safe and protect their health before, during, and after environmental crises. These efforts build on a recent EPA-funded project in which she worked with a team of communication researchers to improve guidelines for communicating with stakeholders, the media, and the public after decontamination and clearance of water emergencies.

In coming months, Hoover also will assume co-PI duties for management of the National Health Security Preparedness Index, a tool initially developed by CDC, the Association of State and Territorial Health Officials, and other key preparedness constituencies to assess the nation’s ability to prevent, respond to, and recover from public health threats. In this capacity, Hoover will coordinate stakeholder involvement in Index development while working closely with the Robert Wood Johnson Foundation to enhance the Index’s dissemination and utility for supporting decision-making in both policy and practice.

Highlighted Publications

  • Johnson JD, Hoover AG. 2013. When people outside the organization need information: strategically communicating with external stakeholders. In JS Wrench (ed.), Workplace communication for the 21st century: tools and strategies that impact the bottom line (vol. 2). Santa Barbara, California: Praeger.
  • Hoover AG. 2013. Commentary: changing the channel: public health communication in the 21st century. Frontiers in Public Health Services and Systems Research 2(1): Article 6. [Abstract]
  • Hoover AG. 2013. Communication at Superfund sites and the reification of division: toward a convergence-building model of risk communication. [Dissertation]
  • Mays GP, Hogg RA, Castellanos-Cruz DM, Hoover AG, Fowler LC. 2013. Public health research implementation and translation: evidence from practice-based research networks. Am J Prev Med 45(6):752-762. [Abstract]

Select presentations can be found in Hoover’s online archive.

Neasha Graves – Translating Environmental Health Research Through Education

Neasha Graves, left, speaks with Marti Lindsey, Ph.D., of the University of Arizona at a PEPH meeting.

Neasha Graves, left, speaks with Marti Lindsey, Ph.D., of the University of Arizona at a PEPH meeting.
(Photo courtesy of Steve McCaw)

Neasha Graves has a unique perspective on environmental health education thanks to her experiences in high school teaching and adult literacy education. She combines this perspective with a passion for providing vulnerable people with the tools they need to succeed, when she designs training workshops and materials that educate children, parents, and professionals about environmental health issues.

Graves’ first foray into environmental education was as a North Carolina Governor’s Public Management Fellow in the NC Department of Environment and Natural Resources (DENR). She received this fellowship while working on her master’s degree in public administration at North Carolina Central University. At DENR, Graves was a statewide coordinator for the childhood lead poisoning prevention program, which involved conducting training and education that helped health professionals, lay people, and parents understand how to prevent lead poisoning in young children.

In 2006, Graves went to the University of North Carolina, Chapel Hill as the project coordinator for the Community Outreach and Engagement Core (COEC) of the NIEHS-funded Center for Environmental Health and Susceptibility (CEHS). The COEC, which is directed by Kathleen Gray, translates Center research on such topics as asthma and air quality, breast cancer, obesity, shale gas, and skin cancer into knowledge that can improve public health.

Every single day I see my past work in adult literacy affect how I say something to a layperson, how I convey information, or how I type an email. I’m careful to make sure that the lay audience understands what we’re saying. – Neasha Graves

As an educator, Graves finds it very fulfilling to tap into her drive and the great resources at UNC to provide environmental health education that many people need. The COEC acts as a bridge between researchers and community audiences and the professionals who serve the community. Graves says that the COEC continues to see more and more researchers, especially young investigators, who are interested in having a direct connection to community audiences.

In the COEC, she and her colleagues create research-based materials for lay audiences, such as parents who may be dealing with an issue regarding their children. Her past educational experiences directly affect her point of view in terms of how information is conveyed verbally and in print. For example, she notes that when developing materials for a lay audience, it is important to keep in mind that a significant number of people have low literacy levels.

Graves also helps develop programming, materials, and hands-on activities for professionals who may not be aware of environmental exposures and human health risks. For example, the COEC provides a training on environmental asthma triggers that is delivered mostly to nurses and social workers. During this training, participants receive a kit with tactile examples of household asthma triggers. This kit gives the professionals a powerful hands-on tool they can use when talking to a parent or a child or even when teaching a group.

Graves finds it very rewarding to see the “light bulb” moment when a professional who has been trying to help a family deal with asthma receives a trigger kit. Those who have used this hands-on educational tool report that it is more impactful than handing out a brochure or flier.

Her work also entails coordinating the outreach activities of the NIEHS-funded UNC Breast Cancer and Environment Research Program (BCERP). In this role, Graves and Gray work with project co-leaders Melissa Troester, Ph.D., and Liza Makowski, Ph.D., to develop educational tools on breast cancer. Troester and Makowski study the environmental influences on basal-like breast cancer in black women under 50. Graves and her colleagues worked with the UNC School of Information and Library Science on an interactive website, My Breast Cancer Risk, designed to help young black women understand their risk for breast cancer.

Graves says that she finds it very satisfying to know that the small group that makes up the COEC has a real impact on building capacity in terms of understanding environmental health issues. By reaching out to health professionals with train-the-trainer modules and providing them with tools like the asthma trigger kit, they are bringing environmental health education to many people across North Carolina.

Highlighted Publication

  • Allicock M, Graves N, Gray K, Troester MA. 2013. African American women's perspectives on breast cancer: implications for communicating risk of basal-like breast cancer. J Health Care Poor Underserved 24(2):753-767. [ Abstract]

Viola “Vi” Waghiyi – Fighting for Environmental Justice in the Arctic

Vi Waghiyi
Vi Waghiyi (Photo courtesy of Vi Waghiyi)

Viola “Vi” Waghiyi is a Yupik mother and grandmother originally from Savoonga, Alaska, a community on St. Lawrence Island (SLI), which is close to Russia’s Far East. The island has a small population, but it has found itself in the midst of large environmental issues.

When Alaska Community Action on Toxics (ACAT) hired Waghiyi in 2002, she initially worked on its St. Lawrence Island Environmental Health and Justice Project, which focused on the toxic waste left by the U.S. Air Force on the island’s Northeast Cape. ACAT’s NIEHS-funded community-based participatory research (CBPR) has demonstrated the presence of high levels of polychlorinated biphenyls (PCBs) at the former military site, and Waghiyi is working hard to illuminate the potential links between the waste at the Northeast Cape and a variety of health harms, including cancer and reproductive complications.

As part of its CBPR project, ACAT is also examining two endocrine-disrupting chemicals: polybrominated diphenyl ethers (PBDEs) and perfluorinated compounds (PFCs). In addition to examining SLI residents’ exposure to these chemicals, the project offers training so that residents can take action to protect themselves from contamination.

Waghiyi now serves as ACAT’s Environmental Health and Justice Program Director and works on projects that go beyond—but still affect—Alaska. For example, one of ACAT’s (and the Yupik people’s) major concerns is the distribution of persistent organic pollutants (POPs), including PCBs, throughout the world. The Arctic acts as a sink for such pollutants, and SLI data have shown a connection between high PCB levels in the marine mammals that make up the Yupik diet and PCB levels in the Yupik themselves.

Such environmental concerns are not just a matter of health but also of justice. According to the U.S. Census Bureau, the poverty rate of SLI’s two communities, Gambell and Savoonga, is 38.7% and 53.3%, respectively. (The overall U.S. poverty rate is 14.9%.) Thus, poor, indigenous communities have to deal with the consequences of chemicals created and released thousands of miles away, and this injustice prompted ACAT to participate in a recent campaign that framed pesticide production and distribution as a human rights issue.

It’s not a matter of ‘if I will’ but ‘when I will’ get cancer. – Vi Waghiyi

Another avenue for addressing this problem is the Stockholm Convention, a treaty that “requires its parties to take measures to eliminate or reduce the release of POPs into the environment.” During the Convention’s fifth Conference of the Parties (COP 5) in 2011, Waghiyi participated in the Global Indigenous People’s Caucus, which informed the COP 5’s official decision to add the pesticide endosulfan to the UN’s list of POPs to be eliminated worldwide. In 2013, Waghiyi led a delegation of indigenous women to the COP 6 meeting and succeeded in calling for a ban on the flame retardant hexabromocyclododecane (HBCD).

Waghiyi’s work is vital because it reminds us that environmental health science is not an abstract field; researchers need to keep in mind that their work has local and personal implications. As a member of the National Advisory Environmental Health Sciences Council, Waghiyi emphasizes the importance of local engagement to the NIEHS mission, and she was pleased when NIEHS and National Toxicology Program Director Linda Birnbaum, Ph.D., visited Alaska for several community forums to learn about the many local environmental health concerns. The residents of St. Lawrence Island live every day with the health and environmental consequences of others’ actions, and Waghiyi asks that we work together to mitigate and prevent this “contamination without our consent.”

Highlighted Publications

  • Miller PK, Waghiyi V, Welfinger-Smith G, Byrne SC, Kava J, Gologergen J, Eckstein L, Scrudato R, Chiarenzelli J, Carpenter DO, Seguinot-Medina S. 2013. Community-based participatory research projects and policy engagement to protect environmental health on St Lawrence Island, Alaska. Int J Circumpolar Health 72:21656. [Abstract]
  • Hoover E, Cook K, Plain R, Sanchez K, Waghiyi V, Miller P, Dufault R, Sislin C, Carpenter DO. 2012. Indigenous peoples of North America: environmental exposures and reproductive justice. Environ Health Perspect 120(12):1645-1649. [Abstract]
  • Welfinger-Smith G, Minholz JL, Byrne S, Waghiyi V, Gologergen J, Kava J, Apatiki M, Ungott E, Miller PK, Arnason JG, Carpenter DO. 2011. Organochlorine and metal contaminants in traditional foods from St. Lawrence Island, Alaska. J Toxicol Environ Health A 74(18):1195-1214. [Abstract]

John Sullivan – Setting the Stage for Healthier Communities

John Sullivan never expected he would have a career in the field of environmental health. He is trained in the arts and has worked as a writer, playwright, director, poet, performance artist, and arts educator. When he learned that the NIEHS-funded Center in Environmental Toxicology (CET) at the University of Texas Medical Branch at Galveston (UTMB) was interested in using theatre to educate and engage environmental justice communities, he saw an opportunity to use his background to help people understand the science behind the issues that were affecting their health and quality of life. Sullivan is now director of the Public Forum and Toxics Assistance (Division 3) within the CET’s Community Outreach and Engagement Core (COEC). He is also an instructor in the UTMB Department of Preventive Medicine & Community Health and an associate member in the Institute for Medical Humanities.

John Sullivan facilitates a Forum Theatre workshop
John Sullivan (center, black shirt) facilitates a Forum Theatre workshop in which residents illustrate a potential heart disease cluster in their community. (Photo courtesy of Citizens for Environmental Justice – Corpus Christi, Texas)

Sullivan uses a technique called Forum Theatre to help communities understand science and to help scientists understand communities. Created by Augusto Boal, a ground-breaking director and playwright from Brazil, Forum Theatre promotes positive community change. The technique encourages the audience, or “spect-actors,” to step into the show when they have a different idea or solution about how to solve the problem being portrayed. “Forum Theatre is community driven, community members create and act in their own shows, the audience is attentive and interactive, and the process gets people to think about realistic ways to solve a community problem,” Sullivan explained

Many Gulf Coast families live in communities bordering oil refineries or industrial plants. These families often cannot afford to move to healthier, safer places. Sullivan organizes Forum Theatre workshops around environmental health issues of immediate concern to these communities. Over the years, workshops have covered topics such as hazardous air pollutants, lead poisoning, environmental asthma triggers, the built environment, and trichloroethene vapor intrusion.

Sullivan also trains community leaders to facilitate their own Forum Theatre workshops. In partnership with the Houston-based community group de Madres a Madres, Sullivan trained a troupe of volunteers in Forum Theatre techniques, and a team of CET researchers taught them about community-relevant environmental health issues. The troupe delivered over 30 bilingual and culturally sensitive performances, raising awareness of childhood lead exposure and environmental asthma triggers and teaching families how to reduce or eliminate these hazards from their homes. The project, Communities Organized against Asthma & Lead (COAL), was funded by the NIEHS Environmental Justice: Partnerships for Communication Program.

More recently, Sullivan has been working alongside Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) project. GC-HARMS is one of several projects funded by the NIEHS to examine the health effects stemming from the 2010 Deepwater Horizon oil spill. The goal of GC-HARMS is to examine the impact of the oil spill on seafood safety and ultimately develop seafood consumption guidelines.

Sullivan helps coordinate the community involvement component of GC-HARMS, giving presentations to local fishermen about how the knowledge gained from the project could benefit their families and communities and training them to collect samples. The fishermen used their local knowledge of inland and coastal waters to develop with the exposure assessment team a multi-species sampling matrix that eventually became a GPS-coded map of all of the project sampling sites. “I’ve been closely connected with the local fishermen for several years now and working with them has been a really rewarding part of this project. We couldn’t do this without their help and knowledge of the local environment,” said Sullivan.

For more information, including a video and articles, about some of the workshops Sullivan has facilitated, visit the UTMB Center to Eliminate Health Disparities’ Forum Theatre Skills & Concept Demonstration page.

Highlighted Publications

  • Sullivan J. 2010. Engaging neighbors, transforming toxic realities: community environmental forum theatre using Augusto Boal’s Theatre of the Oppressed to promote environmental justice. In: Creative Arts in Interdisciplinary Practice: Inquiries for Hope and Change (McLean CL, Kelly R, eds). Edmonton: Brush Education.
  • Sullivan J, Lloyd RS. 2007. The forum theatre of Augusto Boal: a dramatic model for dialogue and community-based environmental science. Local Environment: The International Journal of Justice and Sustainability 11(6):627-646. [Abstract]

Erin Haynes, Dr.P.H. – Partnering for Healthier Communities

Erin Haynes, Dr.P.H
Erin Haynes, Dr.P.H. (Photo courtesy of University of Cincinnati)

Erin Haynes has always loved both people and the environment, so when she first learned about the field of environmental health as an undergrad at Wilmington College of Ohio, she saw the perfect opportunity to marry her two passions. Haynes has since dedicated her life to studying how chemicals in the environment affect people and to working with communities to ensure they understand how to protect their health.

After receiving her Dr.P.H. in Environmental Health Science from the University of Michigan’s School of Public Health, Haynes was hired as a postdoctoral fellow in the NIEHS T32 Molecular Epidemiology in Children’s Environmental Health training program. From there, she moved to the University of Cincinnati (UC), where she now serves as an associate professor and director of the UC master’s program in Clinical and Translational Research. Haynes played an integral role in establishing and shaping the program, which offers a community-based participatory research course that emphasizes the role of community engagement in clinical research.

Haynes is also director of the UC Community Outreach and Engagement Core (COEC) within the NIEHS-funded Center for Environmental Genetics and is currently leading three community-based research projects in Ohio. All three studies were prompted by community concerns about local air quality and its effect on health.

Through the Communities Actively Researching Exposure Study (CARES), Haynes has been studying how airborne manganese emissions from a Marietta, Ohio industrial plant are affecting local children’s health. The community helped shape the research direction of CARES. After meeting with community groups and sharing with them what was known about the health effects of manganese, the question of how exposure was affecting their children’s mental development stood out as the major concern. This was also a primary question among scientists at the time.

The communities I work with influence the path of my research. I listen to their questions and concerns which then drive the research. My research has benefited tremendously from community involvement.  – Erin Haynes, Dr.P.H.

Before launching CARES, Haynes conducted a community-wide survey and learned that Marietta residents looked primarily to physicians and journalists to get environmental health information. In response, Haynes and her UC COEC colleagues developed educational resources, including modules for physicians and nurses and a video for journalists, to ensure they had accurate information to educate the community about air pollution and health.

Since starting CARES, Haynes has partnered with a second Ohio community, East Liverpool, which also experiences high levels of airborne manganese. Haynes first learned of the manganese issue in East Liverpool after residents, who had heard of her work in Marietta, expressed their desire to have a similar study conducted in their community. Haynes is now replicating CARES in East Liverpool, and she has also teamed up with colleagues from the UC College of Engineering to develop a portable sensor that can measure blood metal levels in real time. This partnership was driven by Haynes’s desire to get results back to CARES participants faster than the six to nine months it can take to analyze samples using traditional blood-testing methods. Both CARES studies and the development of the sensor are funded by NIEHS.

Erin Haynes and Caroline Beidler
Erin Haynes, Dr.P.H., right, with Neighbors for Clean Air founder Caroline Beidler, who played an integral role in sharing community concerns about air quality. (Photo courtesy of University of Cincinnati)

Most recently, community members have expressed concerns about how chemicals used in the hydraulic fracturing (fracking) process could affect their health. Their concerns have prompted Haynes to initiate two community-engaged research projects. She worked with COECs at the University of Rochester and the University of North Carolina, Chapel Hill to gauge community perception of fracking. She has also teamed up with researchers from Oregon State University to study the effects of fracking on air quality in Carroll County, Ohio, which contains a growing number of fracking sites. To do this, the researchers set up passive air sampling devices at residences near fracking sites and also enlisted study participants to wear personal wristband monitors. The stationary sampling devices can measure more than 1,000 chemicals in the air.

Under Haynes’s leadership, the UC COEC received a community-health award for helping protect families from exposures associated with demolition of a lead-painted bridge in their neighborhood. UC COEC staff created bilingual educational materials and talked with residents about ways to keep their families safe from lead exposure. Intervention was also a critical part of the project – the COEC gave out sticky mats to pick up lead dust from people’s shoes before they entered their homes.

What’s next for Haynes? She hopes to continue following the CARES children to examine the effects of manganese and other metals on their behavior, brain chemistry, structure, and function. According to Haynes, the community continues to ask questions and is very interested in keeping CARES alive and in expanding it to study manganese-induced Parkinsonism in adults. She also hopes to continue her fracking research so that she can provide answers to community questions about potential health effects and provide training for emergency response crews who respond to spills or fires related to the process.

Highlighted Publications

  • Rugless F, Bhattacharya A, Succop P, Dietrich KN, Cox C, Alden J, Kuhnell P, Barnas M, Wright R, Parsons PJ, Praamsma ML, Palmer CD, Beidler C, Wittberg R, Haynes EN. 2014. Childhood exposure to manganese and postural instability in children living near a ferromanganese refinery in Southeastern Ohio. Neurotoxicol Teratol 41:71-79. [Abstract]
  • Parin ML, Yancey E, Beidler C, Haynes EN. 2014. Efficacy of environmental health e-training for journalists. Studies in Media and Communication 2(1): 71-80. [Abstract]
  • Korfmacher KS, Elam S, Gray KM, Haynes EN, Hughes MH. 2014. Unconventional natural gas development and public health: toward a community-informed research agenda. Rev Environ Health. [Abstract]
  • Haynes EN, Ryan P, Chen A, Brown D, Roda S, Kuhnell P, Wittberg D, Terrell M, Reponen T. 2012. Assessment of personal exposure to manganese in children living near a ferromanganese refinery. Sci Total Environ 427-428:19-25. [Abstract]
  • Haynes EN, Beidler C, Wittberg R, Meloncon L, Parin M, Kopras EJ, Succop P, Dietrich KN. 2011. Developing a bidirectional academic-community partnership with an Appalachian-American community for environmental health research and risk communication. Environ Health Perspect 119(10): 1364-1372. [Abstract]

Annie Belcourt, Ph.D. - Increasing Awareness of Native American Environmental Health Disparities

Annie Belcourt, Ph.D.

Annie Belcourt, Ph.D.
(Photo courtesy of Annie Belcourt, Ph.D.)

American Indian and Alaska Native (AI/AN) peoples suffer from both a historic legacy of trauma (stemming from European colonization) and current socioeconomic disparities. According to the U.S. Census Bureau, AI/AN peoples have higher rates of poverty, lower median incomes, and lower rates of high school and college completion. In addition, according to the Centers for Disease Control and Prevention, AI/AN peoples have higher rates of infant mortality; substandard housing; smoking; binge drinking; and death from drug abuse, motor vehicles, and suicide.

Annie Belcourt (Otter Woman), an enrolled member of the Three Affiliated Tribes and a descendent of the Blackfeet and Chippewa, is working to address these health issues. Belcourt received her Ph.D. in clinical psychology from the University of Montana and currently teaches at its School of Public & Community Health Sciences and Department of Pharmacy Practice.

In addition to her psychological research on trauma, Belcourt also has participated in environmental health research. Health problems related to environmental exposures play a large role in the lives of Native Americans in Montana. This includes poor water quality stemming from factors such as hydraulic fracturing and a lack of safe water supplies and waste disposal facilities, as well as poor indoor air quality related to mold, wood stoves, and tobacco.

Belcourt is working to improve indoor air quality in two Native American communities, Nez Perce and the Navajo Nation, as part of an NIEHS-funded, two-level health intervention. Highlighting the health risks associated with burning wet wood, the researchers are helping the communities establish wood banks so that residents have access to dry wood for fuel. At the household level, the researchers are comparing the efficacy of (1) an educational intervention focusing on healthy wood-burning practices with (2) an indoor air-filtration system and (3) a placebo (dummy air filters).

Belcourt conducts focus groups and key-informant interviews to help make the educational intervention accessible and culturally appropriate. Part of the intervention involves digital storytelling, a format that allows Native Americans (and others) to create and distribute their own stories in their own words and, in turn, promote health and environmental protection. Storytellers receive training on scriptwriting and digital technology, and they own the rights to their material. The format enables community members to weave together personal narrative, reflections on Native American spirituality, and activism using their native language and images. (See some examples of digital stories from nDigiDreams, which conducts media workshops with Native American communities.)

More broadly, Belcourt is part of the University of Montana’s push to hire more Native American tenure-track professors, and she believes that the key to bringing more Native Americans into academia lies in developing the infrastructure to do so. She is grateful for the postdoctoral research opportunities she had with the Native Elder Research Center and the Indigenous HIV/AIDS Research Training Program, which allowed her to interface with other Native scholars from around the country, and for the support that the National Institute on Minority Health and Health Disparities provided through an endowment grant to the University of Montana – a grant that allowed the University to hire her.

NIEHS is pleased to be a part of Annie Belcourt’s career development and to support her involvement in interdisciplinary research that combines environmental science, cultural literacy, and educational interventions – research that is necessary to address Native American health disparities.

Highlighted Publications

  • Beals J, Belcourt-Dittloff A, Garroutte EM, Croy C, Jervis LL, Whitesell NR, Mitchell CM, Manson SM; AI-SUPERPFP Team. 2013. Trauma and conditional risk of posttraumatic stress disorder in two American Indian reservation communities. Soc Psychiatry Psychiatr Epidemiol 48(6):895-905. [Abstract]
  • Jervis LL, Spicer P, Belcourt A, Sarche M, Novins DK, Fickenscher A, Beals J; AI-SUPERPFP Team. 2014. The social construction of violence among Northern Plains tribal members with antisocial personality disorder and alcohol use disorder. Transcult Psychiatry 51(1):23-46. [Abstract]
  • Kelley A, Belcourt-Dittloff A, Belcourt C, Belcourt G. 2013. Research ethics and indigenous communities. Am J Public Health 103(12):2146-2152. [Abstract]

Asa Bradman, Ph.D. – Advocating for Children's Environmental Health

"Children are not little adults!" This refrain that one sometimes hears in the medical world reminds us that we must take into account children's distinct developmental and physiological concerns. What is true in the clinical setting also applies to environmental exposures. Children eat, breathe, and drink more than adults (per unit of body weight); they engage in behaviors that increase their levels of exposure (e.g., crawling on the floor, putting their hands into their mouths); and their bodies are less able to metabolize and remove chemicals to minimize toxic effects. Since children’s bodies change so rapidly, environmental exposures may impact developmental trajectories.

Asa Bradman, Ph.D. receiving an IPM (Integrated Pest Management) Innovator Award

Asa Bradman, Ph.D. receiving an IPM (Integrated Pest Management) Innovator Award.
(Photo courtesy of the Center for Environmental Research & Children's Health)

Asa Bradman knows this better than most. Though he started his career working in environmental chemistry, particularly focusing on acid rain and snow melt chemistry in the Rockies, he later became interested in research that was more directly engaged with people and their wellbeing. He worked for several years at the California Department of Public Health, a crucible for the emerging field of children's environmental health in the 1980s, and he immersed himself in the issue of pediatric lead exposure while completing his Ph.D. in environmental health sciences. He later cofounded the University of California – Berkeley's Center for Environmental Research and Children's Health(CERCH), where he currently serves as its Associate Director for Exposure Assessment.

Under CERCH’s CHAMACOSproject, which is examining the connection between environmental exposures and health in a cohort of children (birth through 14 years) in California’s Salinas Valley, he has led studies on pesticide and flame-retardant exposures in pregnant women and children. These exposures have been associated with poorer neurodevelopment in the CHAMACOS children.

Bradman’s flame-retardant work has had a particularly significant impact. Because of the Golden State’s flammability standards that resulted in heavy use of chemicals, the flame-retardant levels in California children are much higher than in children elsewhere. As a result, Governor Jerry Brown has ordered new regulations that meet fire-safety goals and minimize or eliminate chemical exposures.

(Under a new NIEHS-funded grant, Bradman is continuing this line of research by examining the exposure of mothers to organophosphate flame retardants (OPFRs), the prenatal exposure of their children to OPFRs, and the subsequent neurodevelopment of those children.)

Bradman also has focused on the environmental health risks in childcare centers. Under a contract with the California Air Resources Board, he conducted a groundbreaking studyof the level of formaldehyde(305KB) (a human carcinogen) and other toxins in childcare centers. He and other researchers also developed an integrated pest management (IPM) curriculum for childcare professionals. IPM is a healthier, more environmentally sound method of dealing with pests; it either avoids chemicals altogether or (if chemicals prove necessary) aims for the least toxic options. For his effort, Bradman won a 2012 IPM Innovator Awardfrom the California Department of Pesticide Regulation.

[We need] careful evaluation of indoor environments and the materials that are used there, particularly when we're thinking of very young children.  – Asa Bradman, Ph.D.

Bradman would like more resources put toward understanding environmental exposures in childcare and school environments. He sees big opportunities to support education and outreach that can inform decisions about the materials used in indoor environments and thereby reduce chemical exposures to children.

More broadly, Bradman stresses that when we consider widely used chemicals like flame retardants, we should note that virtually every American has these chemicals in their bodies. Thus, we must ensure that decisions to use chemicals that will expose all of us, starting in the womb, are fully informed and protect public health.

Highlighted publications

  • Bradman A, Castorina R, Gaspar F, Nishioka M, Colón M, Weathers W, Egeghy PP, Maddalena R, Williams J, Jenkins PL, McKone TE. 2014. Flame retardant exposures in California early childhood education environments. Chemosphere. [Epub ahead of print] [Abstract]
  • Bradman A, Castorina R, Sjödin A, Fenster L, Jones RS, Harley KG, Chevrier J, Holland NT, Eskenazi B. 2012. Factors associated with serum polybrominated diphenyl ether (PBDE) levels among school-age children in the CHAMACOS cohort. Environ Sci Technol 46(13):7373-7381. [Abstract]
  • Bradman A, Kogut K, Eisen EA, Jewell NP, Quirós-Alcalá L, Castorina R, Chevrier J, Holland NT, Barr DB, Kavanagh-Baird G, Eskenazi B. 2013. Variability of organophosphorous pesticide metabolite levels in spot and 24-hr urine samples collected from young children during 1 week. Environ Health Perspect 121(1):118-124. [Abstract]
  • Eskenazi B, Bradman A, Finkton D, Purwar M, Noble JA, Pang R, Burnham O, Cheikh Ismail L, Farhi F, Barros FC, Lambert A, Papageorghiou AT, Carvalho M, Jaffer YA, Bertino E, Gravett MG, Altman DG, Ohuma EO, Kennedy SH, Bhutta ZA, Villar J; International Fetal and Newborn Growth Consortium for the 21st Century. 2013. A rapid questionnaire assessment of environmental exposures to pregnant women in the INTERGROWTH-21st Project. BJOG 120(Suppl 2):129-138. [Abstract]
  • Gunier RB, Bradman A, Jerrett M, Smith DR, Harley KG, Austin C, Vedar M, Arora M, Eskenazi B. 2013. Determinants of manganese in prenatal dentin of shed teeth from CHAMACOS children living in an agricultural community. Environ Sci Technol 47(19):11249-11257. [Abstract]

Allison Patton and Kevin Lane – Working with communities to understand near-highway air pollution

Collaboration between environmental health scientists and community groups provides researchers a unique opportunity to strengthen the research process and translate findings to improve community health and inform policy. The NIEHS recognizes the value of community involvement in scientific research and funds many projects that use community-based participatory research (CBPR) approaches. In turn, many of those projects are training a new generation of graduate students and postdoctoral fellows to utilize CBPR methods.

Two such trainees, Allison Patton and Kevin Lane, work on the Community Assessment of Freeway Exposure and Health (CAFEH) (PI: Doug Brugge, Ph.D.) study at Tufts University. CAFEH is working with Boston-area communities to ascertain the relationship between near-highway residential areas and adverse health outcomes. In partnership with local community groups — such as the Chinatown Resident Association, the Chinese Progressive Association, the Committee for Boston Public Housing, and the Somerville Transportation Equity Partnership — CAFEH has conducted research, analyzed results, and published various journal articles, newsletters, and fact sheets regarding particulate matter and the relationship between traffic pollution and health.

Allison Patton received her Bachelor of Science in Environmental Engineering from MIT and is currently a doctoral student in Tufts University’s Civil and Environmental Engineering department; she is also a fellow in the U.S. Environmental Protection Agency (EPA) Science to Achieve Results (STAR) program. She likes measuring the world around her and felt that environmental engineering offered a good way of combining her interests with helping people.

Allison Patton (center) working on top of CAFEH’s mobile lab with fellow students Jeff Trull (left) and Jessica Perkins (right)
Allison Patton (center) working on top of CAFEH’s mobile lab with fellow students Jeff Trull (left) and Jessica Perkins (right)
(Photo courtesy of Tufts University)

Under the CAFEH study, Patton investigates particulate matter concentrations at varying distances from Interstate 93. For her thesis, she has developed models that predict ambient ultrafine particle (UFP) number concentrations in the study-area neighborhoods under a variety of traffic and meteorological conditions.

Patton measured particulate matter concentrations at different times of day and through different seasons and was in charge of much of the mobile monitoring near the highway, which involved compiling the data and performing quality control.

Patton did not always think her work would involve a major community or public policy component. She figured that she would follow the path of many academics: conduct research, publish findings, and then have the scientific community use her findings to pursue further research. However, she is working on making the data in her models more visual and suitable for those who want to use them for policy development. In addition, she has learned that community members want practical ways to implement research findings. She explained, for example, that people who regularly exercise near a highway should try to avoid doing so during rush hour (when particulate matter concentrations are at their highest), and people who do exercise at a higher-risk time should try to move away from the highway; even just moving to another side of a building — away from the road — can reduce exposure.

More broadly, Patton says that increasing the use of public transportation would decrease air pollution related to traffic congestion (though, she notes, public transportation is losing funding at a time when more people want to switch to it).

Kevin Lane is a doctoral student in environmental health at Boston University and is also an adjunct faculty member in the university’s City Planning and Urban Affairs program. He was a recipient of the Ruth L. Kirschstein National Research Service Award  and is now a fellow in the EPA STAR program. His interest in environmental science and policy developed early when he was an undergraduate at St. Michael’s College, majoring in biology and political science, and when he worked as an intern at the New Hampshire Department of Environmental Services, where he conducted quality assurance/control of data and filter analysis for air pollution.

Kevin Lane discusses with community members how ultrafine particulate matter spreads across the CAFEH study areas.

Kevin Lane discusses with community members how ultrafine particulate matter spreads across the CAFEH study areas.
(Photo courtesy of Doug Brugge)

He says he was “thrown into the fire,” however, when he spent three-and-a-half years working as a research assistant for the Harvard School of Public Health’s Trucking Industry Particle Study. He collected air pollution data in working conditions involving high PM2.5 concentrations, and he reported feeling ill himself after coming home from fieldwork.

While a master’s student in Tufts’ Urban and Environmental Policy and Planning program, his professors convinced him that he could contribute the most to society if he focused on the intersection of science and policy. They said that there are plenty of lawyers to work on the policy front, but more work is needed on science translation and the effective use of epidemiological information in policy development.

“[Community participation] helps train us as doctoral students...to be better translators of science so that we’re not just living in the ivory tower. We’re able to actually communicate with everyday citizens and people that are actually being affected by these pollutants.  - Kevin Lane

Under the CAFEH study, Lane investigates the health associations between hourly UFP (from Patton’s models) and markers of cardiovascular health. He conducts data and statistical analysis and serves as the geographic information system (GIS) specialist. The latter involves building maps and collaborating with community members to make sure the maps are accurate — even down to the apartment level — to get as close as possible to the research subjects’ personal exposure levels.

Lane sees policy implications for the CAFEH research. He says that at the federal level, more and larger human epidemiological studies of UFP are needed to inform regulatory determinations. In addition, if roadways are indeed the primary sources of UFP, then more local or mobile monitoring will be needed to capture air pollution data from where people actually live and work.

At the local level, he says that officials and community members could help to inform ordinances that reduce exposure to near-roadway air pollution, such as prohibiting new construction of certain buildings (e.g., schools, public housing complexes) within 200 meters of roadways or requiring HEPA filtration systems for existing buildings. He adds that including policy officials throughout the entire course of an environmental health study is vital. By getting involved early, the officials become familiar with the concerns of community members and researchers and can start to consider policy ideas in tandem with data collection and analysis.

Lane is very happy that community members form an integral part of his research. He recognizes the importance of translating his statistical work at public presentations so that residents can then spread the word to their neighbors and peers. He sees this research communication and translation as an important part of his doctoral program that will help him throughout his career.

Highlighted Publications

  • Brugge D, Lane K, Padró-Martínez LT, Stewart A, Hoesterey K, Weiss D, Wang DD, Levy JI, Patton AP, Zamore W, Mwamburi M. 2013. Highway proximity associated with cardiovascular disease risk: the influence of individual-level confounders and exposure misclassification. Environ Health 12(1):84. [Abstract]
  • Fuller CH, Patton AP, Lane K, Laws MB, Marden A, Carrasco E, Spengler J, Mwamburi M, Zamore W, Durant JL, Brugge D. 2013. A community participatory study of cardiovascular health and exposure to near-highway air pollution: study design and methods. Rev Environ Health 28(1): 21-35. [Abstract]
  • Lane KJ, Kangsen Scammell M, Levy JI, Fuller CH, Parambi R, Zamore W, Mwamburi M, Brugge D. 2013. Positional error and time-activity patterns in near-highway proximity studies: an exposure misclassification analysis. Environ Health 12(1):75. [Abstract]
  • Padró-Martínez LT, Patton AP, Trull JB, Zamore W, Brugge D, Durant JL. 2012. Mobile monitoring of particle number concentration and other traffic-related air pollutants in a near-highway neighborhood over the course of a year. Atmos Environ 61:253-264. [Abstract]

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