- PUBHLTH554: Introduction to Globalization and Health
- M.P.H., Occupational Health, University of Michigan, 1983
- M.D., , Tufts University, 1979
- A.B., Philosophy, Harvard University, 1972
Research Interests & Projects
Issues in Exposure Assessment
The critical limitation in most occupational and environmental epidemiologic studies involves problems in exposure assessment rather than in the assessment of disease outcomes. My research efforts attempt to address several key difficulties in the area of exposure assessment including: appropriate methods of using exposure information collected on groups to model individual exposures, the inclusion of information on particle size distribution in assessing dose and dose-response relationships, and strategies to assess complex, mixed exposures including bioaerosols.
Epidemiology of Inhaled Toxins
(1) Coal dust
The effects of coal dust exposure on the respiratory tract are complex. Long term work as a coal miner at relatively high exposures has been associated with the risk for pneumoconiotic X-ray changes which may be accompanied by a restrictive pattern of pulmonary function. In addition, at perhaps lower exposures, coal mining is associated with chronic bronchitis and obstructive PFT changes. United States. We evaluated exposure-response relationships among coal miners who began work only after the institution of the U.S. Coal Dust Standard in 1970 Coal miners had very marked, statistically significant, exposure-related decrements in FEV1 and FVC during their first five years of work but no subsequent dose-related decrements. South Africa. We are currently conducting the first-ever epidemiologic study of the respiratory health of coal miners in South Africa. Because South Africa has a unique resource, i.e., standardized autopsy data on the hearts and lungs of tens of thousands of miners, this venue offers the opportunity to make the most comprehensive assessment ever of the relationships between dust exposure and chest radiograph and pulmonary function findings with specific pathologic diagnoses.
(2) Occupational and environmental asthma.
Metalworking fluids. Our study of acute respiratory effects associated with inhalational exposure to metalworking fluid aerosols in an automotive transmission plant resulted in a number of novel findings: large cross shift decrements in FEV1 and FVC were seen in those with exposure but not in unexposed controls, significant associations of cross shift decrements in FEV1 and FVC were demonstrated with exposure to bacteria; and these associations were much more pronounced in workers with lower baseline (Monday pre-shift) FEV1/FVC ratios. Our identification of the first case series of machinists with biopsy proven hypersensitivity pneumonitis played an important role in establishment of an association of this disease entity with metalworking fluids. (publication # 38).
Seafood processing workers. Work in the seafood industry provides an excellent model for IgE mediated occupational asthma caused by exposure to high molecular weight substances. Our current investigation of occupational allergic conditions among seafood processing workers in the Western Cape of South Africa exposed to both crustaceans and bony fish entails a comprehensive approach including novel exposure characterization methods, field methacholine challenge testing, and skin, patch, and serum RAST testing.
Ambient air pollution and childhood asthma. United States. Our current epidemiologic study of childhood asthma in Detroit employs a longitudinal design including a comprehensive approach to the measurement of outdoor and indoor environmental exposures and extensive measures of key psychosocial variables. It is closely intertwined with a household and neighborhood level intervention study. The chief hypothesis is that fluctuations in ambient air pollution measures, particularly PM and ozone, will be mediated or potentiated by specific indoor pollutants, in particular allergens, to cause fluctuations in measures of health status (symptoms, medications, pulmonary function tests). South Africa. We are currently investigating the respiratory health of students and teachers at a primary school located in Durban between two major oil refineries. The relationship between hourly and daily fluctuations in air pollutants measured continuously on the school grounds and fluctuations in respiratory symptoms and pulmonary function tests are being examined Methodologies employed include baseline comprehensive questionnaires and PFTs including non-specific challenge testing and/or bronchodilator response, exhaled nitric oxide, and, bihourly during the schoolday, completion of symptom/activity logs and digitally recorded peak flow/FEV1 measures.
We conducted a study of semen quality and fertility among in employed in a South African lead acid battery plant (publication # 40). Abnormal sperm morphology was significantly associated with higher measures of current blood lead, cumulative blood lead, and duration of exposure.
( 4) DDT
The current proposed worldwide ban on the manufacture and export of DDT has created tremendous controversy with strong support from environmental groups and significant concerns from malaria control experts. Spray applications of DDT inside of domiciles continue to be used widely in the developing world to control exposure to malaria vector mosquitoes. The chief metabolite of DDT -- p,p'-DDE -- is a potent anti-androgen. We recently completed a study of male malaria vector control workers spraying the inside of domiciles in the Northern Province of South Africa. We demonstrated intriguing consistent associations between elevated serum levels of several DDT metabolites and increased levels of both baseline and post-GnRH-challenge-changes of estradiol and testosterone.Epidemiology of Inhaled Toxins
United Automobile Workers Hazardous Materials Worker Health and Safety Training
Sponsor: International Union, UAW
Michigan Center for the Environmental and Children's Health - Exposure Core
The University of Michigan Education and Research Center - Center Administration Core
The University of Michigan Education and Research Center - NORA Core
Research Training in Environmental and Occupational Health in Southern Africa
DEARS Recruitment Study
- Batterman, S. J. Burke, V. Isakov, T. Lewis, B. Mukherjee and T. Robins (2014). A comparison of exposure metrics for traffic-related air pollutants: application to epidemiology studies in detroit, michigan. Int J Environ Res Public Health 9553-77.
- Batterman S, L. Du, E. Parker, T. Robins, T. Lewis, B. Mukherjee, E. Ramirez, Z. Rowe and W. Brakefield-Caldwell (2013). Use of Free-standing Filters in an Asthma Intervention Study. Air Qual Atmos Health 759-767.
- Lewis T.C, T.G. Robins, G.B. Mentz, X. Zhang, B. Mukherjee, X. Lin, G.J. Keeler, J.T. Dvonch, Y.F. Yip, M.S. O'Neill, E.A. ParkerA, B.A. Israel, P.T. Max and A. Reyes. (2013). Community Action Against Asthma (CAAA) Steering Committee. Air pollution and respiratory symptoms among children with asthma: vulnerability by corticosteroid use and residence area Science of the Total Envrionment 48-55.
- Sampson N.R., E.A. Parker, R.R. Cheezum, T.C. Lewis, A. O'Toole, J. Patton, A. Zuniga, T.G. Robins and C.C. Keirns (2013). A life course perspective on stress and health among caregivers of children with asthma in Detroit. Family Community Health 51-62.
- Sampson N.R., E.A. Parker EA, R.R. Cheezum, T.C. Lewis, A. O'Toole, A. Zuniga, J. Patton, T.G. Robins and C.C. Keirns (2013). "I wouldn't look at it as stress": conceptualizations of caregiver stress among low-income families of children with asthma Journal of Health Care for the Poor and Underserved 275-88.
- Du L, S. Batterman, C. Godwin, J.Y. Chin, E. Parker, M. Breen, W. Brakefield, T. Robins and T. Lewis (2012). Air change rates and interzonal flows in residences, and the need for multi-zone models for exposure and health analyses. Int J. Environ Res Public Health 4639-61.
- Jafta, N., S.A. Batterman, N. Gqaleni, R.N. Naidoo and T.G. Robins (2012). Characterization of allergens and airborne fungi in low and middle-income homes of primary school children in Durban, South Africa. American Journal Ind Medicine 1110-21.
- Reddy P, R.N. Naidoo, T.G. Robins, G. Mentz, H. Li, S.J. London and S. Batterman (2012). GSTM1 and GSTP1 gene variants and the effect of air pollutants on lung function measures in South African children. American Journal Ind Medicine 1078-86.