Graduate Academic Programs' Presentations and Publications

Wildland firefighter exposure to smoke and COVID-19: A new risk on the fire line

Kathleen M Navarro
Kathleen A Clark
Daniel J Hardt
Colleen E Reid
Peter W Lahm
Joseph W Domitrovich
Corey R Butler
John R Balmes
2020

Throughout the United States, wildland firefighters respond to wildfires, performing arduous work in remote locations. Wildfire incidents can be an ideal environment for the transmission of infectious diseases, particularly for wildland firefighters who congregate in work and living settings. In this review, we examine how exposure to wildfire smoke can contribute to an increased likelihood of SARS-CoV-2 infection and severity of coronavirus disease (COVID-19). Human exposure to particulate matter (PM), a component of wildfire smoke, has been associated with oxidative stress and...

Health effects of wildfire smoke in children and public health tools: a narrative review

Stephanie M Holm
Mark D Miller
John R Balmes
2020

Wildfire smoke is an increasing environmental health threat to which children are particularly vulnerable, for both physiologic and behavioral reasons. To address the need for improved public health messaging this review summarizes current knowledge and knowledge gaps in the health effects of wildfire smoke in children, as well as tools for public health response aimed at children, including consideration of low-cost sensor data, respirators, and exposures in school environments. There is an established literature of health effects in children from components of ambient air pollution,...

Differences in the Estimation of Wildfire-Associated Air Pollution by Satellite Mapping of Smoke Plumes and Ground-Level Monitoring

Raj P Fadadu
John R Balmes
Stephanie M Holm
2020

Wildfires, which are becoming more frequent and intense in many countries, pose serious threats to human health. To determine health impacts and provide public health messaging, satellite-based smoke plume data are sometimes used as a proxy for directly measured particulate matter levels. We collected data on particulate matter <2.5 μm in diameter (PM2.5) concentration from 16 ground-level monitoring stations in the San Francisco Bay Area and smoke plume density from satellite imagery for the 2017-2018 California wildfire seasons. We tested for trends and calculated...

Testing for SARS-CoV-2 in Symptomatic Vaccinated and Unvaccinated Health Care Workers During the Delta Variant Surge

Anthony Lopez
Robert Kosnik
Paul D Blanc
Brian R Taylor
Sandeep Guntur
2021
Background:

Infection with SARS- CoV- 2 in health care workers (HCWs) challenges employee health services.

Methods:

We analyzed telephone Coronavirus Disease 2019 (COVID-19) hotline data over 8 weeks in 2021 during SARS- CoV- 2 Delta variant surge. We calculated COVID-19 case rates among persons-under-investigation (PUIs) for illness at two health care centers (HCs).

Results:

There were 41 COVID-19 cases among the 285 PUIs (14.4%) at the study HC and 549 (16.9%) of 3244 at the comparison HC. At the study HC, 11.7% of vaccinated PUIs versus 36.6% of unvaccinated...

Biomass Smoke Exposure and Atopy among Young Children in the Western Highlands of Guatemala: A Prospective Cohort Study

Wenxin Lu
Laura Ann Wang
Jennifer Mann
Alisa Jenny
Carolina Romero
Andrea Kuster
Eduardo Canuz
Ajay Pillarisetti
Kirk R Smith
John Balmes, MD
Lisa Thompson
2022

Women and children in rural regions of low-income countries are exposed to high levels of household air pollution (HAP) as they traditionally tend to household chores such as cooking with biomass fuels. Early life exposure to air pollution is associated with aeroallergen sensitization and developing allergic diseases at older ages. This prospective cohort study assigned HAP-reducing chimney stoves to 557 households in rural Guatemala at different ages of the study children. The children's air pollution exposure was measured using personal CO diffusion tubes. Allergic outcomes at 4-5...

Increased Bloodborne Pathogen Exposure Hotline Utilization During the COVID-19 Pandemic: An Unexpected Phenomenon

Matthew Kiok
Sandeep Guntur, MD, MPH
Paul Blanc, MD, MSPH
Olga Lozato
Grace Domingo
Robert Kosnik
Chika E Ugbaja
Noreen Chan
Alan Ramos
Sandra Domeracki, RN, MSN, FNP-BC, COHN-S, FAAOHN
2022

Background: Mitigating bloodborne pathogen exposure (BBPE) risk among healthcare workers is a major focus of hospital-based occupational health programs. The COVID-19 pandemic has placed added demands on occupational health services for healthcare workers. Its impact on BBPE incidence is unreported. Methods: As part of quality improvement efforts, we examined BBPE case incidence at two affiliated health centers during a 24-month period, 12 months preceding and following the COVID-19 pandemic onset. We used Year 1 to Year 2 change in incidence at the larger health center...

Rare case of occupational pulmonary hemorrhage in a firefighter

Sheiphali A Gandhi
TJ Welch
Kirk D Jones
Kristin J Cummings
Laura Styles
Paul D Blanc
Robert J Harrison
2022

Alveolar hemorrhage associated with physical exertion, known as exercise-induced pulmonary hemorrhage (EIPH), is a rare condition linked to strenuous exertion. This can be an unusual form of respiratory and occupational illness. We present the case of a healthy firefighter who developed fatal pulmonary hemorrhage after participating in a strenuous physical training exercise regimen. This case represents a severe presentation of EIPH, which results from the disruption of the pulmonary blood-gas barrier as a result of strenuous exertion. Clinicians caring for those in vocations and...

Shoulder kinematics during cyclic overhead work are affected by a passive arm support exoskeleton

Giulia Casu
Isaiah Barajas-Smith
Alan Barr, MS
Brandon Phillips
Sunwook Kim
Maury A Nussbaum
David Rempel, MD, MPH
Massimiliano Pau
Carisa Harris-Adamson
2024

Purpose: We investigated the influence of passive arm-support exoskeleton (ASE) with different levels of torque (50, 75, and 100%) on upper arm osteokinematics.

Methods: Twenty participants completed a cyclic overhead drilling task with and without ASE. Task duration, joint angles, and angular acceleration peaks were analyzed during ascent and descent phases of the dominant upper arm.

Results: Maximum ASE torque was associated with decreased peak acceleration during ascent (32.2%; SD 17.8; p < 0.001) and descent phases (38.8%; SD 17.8; p < 0.001). Task duration remained...