Jonathan M Samet

Duke University, Durham, North Carolina, United States

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Publications (489)3557.45 Total impact

  • Heather L Wipfli · Jonathan Samet
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    ABSTRACT: Much has been learned about the tobacco epidemic, including its consequences, effective measures to control it, and the actors involved. This article identifies lessons learned that are applicable to the other principal external causes of noncommunicable diseases: alcohol abuse, poor nutrition, and physical inactivity. Among these lessons are the development of evidence-based strategies such as proven cessation methods, tax increases, and smoke-free policies; the role of multinational corporations in maintaining markets and undermining control measures; and the need for strategies that reach across the life course and that begin with individuals and extend to higher levels of societal organization. Differences are also clear. Tobacco products are relatively homogeneous and have no direct benefit to consumers, whereas food and alcohol consumed in moderation are not inherently dangerous. Some tobacco-related diseases have the singular predominant cause of smoking, while many noncommunicable diseases have multiple interlocking causes such as poor diet, excess alcohol consumption, insufficient physical activity, and smoking, along with genetics. Thus, the tobacco control model of comprehensive multilevel strategies is applicable to the control of noncommunicable diseases, but the focus must be on multiple risk factors.
    Health Affairs 09/2015; 34(9):1480-8. DOI:10.1377/hlthaff.2015.0361 · 4.97 Impact Factor
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    ABSTRACT: Exposure to nicotine in electronic cigarettes (e-cigarettes) is becoming increasingly common among adolescents who report never having smoked combustible tobacco. To evaluate whether e-cigarette use among 14-year-old adolescents who have never tried combustible tobacco is associated with risk of initiating use of 3 combustible tobacco products (ie, cigarettes, cigars, and hookah). Longitudinal repeated assessment of a school-based cohort at baseline (fall 2013, 9th grade, mean age = 14.1 years) and at a 6-month follow-up (spring 2014, 9th grade) and a 12-month follow-up (fall 2014, 10th grade). Ten public high schools in Los Angeles, California, were recruited through convenience sampling. Participants were students who reported never using combustible tobacco at baseline and completed follow-up assessments at 6 or 12 months (N = 2530). At each time point, students completed self-report surveys during in-classroom data collections. Student self-report of whether he or she ever used e-cigarettes (yes or no) at baseline. Six- and 12-month follow-up reports on use of any of the following tobacco products within the prior 6 months: (1) any combustible tobacco product (yes or no); (2) combustible cigarettes (yes or no), (3) cigars (yes or no); (4) hookah (yes or no); and (5) number of combustible tobacco products (range: 0-3). Past 6-month use of any combustible tobacco product was more frequent in baseline e-cigarette ever users (n = 222) than never users (n = 2308) at the 6-month follow-up (30.7% vs 8.1%, respectively; difference between groups in prevalence rates, 22.7% [95% CI, 16.4%-28.9%]) and at the 12-month follow-up (25.2% vs 9.3%, respectively; difference between groups, 15.9% [95% CI, 10.0%-21.8%]). Baseline e-cigarette use was associated with greater likelihood of use of any combustible tobacco product averaged across the 2 follow-up periods in the unadjusted analyses (odds ratio [OR], 4.27 [95% CI, 3.19-5.71]) and in the analyses adjusted for sociodemographic, environmental, and intrapersonal risk factors for smoking (OR, 2.73 [95% CI, 2.00-3.73]). Product-specific analyses showed that baseline e-cigarette use was positively associated with combustible cigarette (OR, 2.65 [95% CI, 1.73-4.05]), cigar (OR, 4.85 [95% CI, 3.38-6.96]), and hookah (OR, 3.25 [95% CI, 2.29-4.62]) use and with the number of different combustible products used (OR, 4.26 [95% CI, 3.16-5.74]) averaged across the 2 follow-up periods. Among high school students in Los Angeles, those who had ever used e-cigarettes at baseline compared with nonusers were more likely to report initiation of combustible tobacco use over the next year. Further research is needed to understand whether this association may be causal.
    JAMA The Journal of the American Medical Association 08/2015; 314(7):700-707. DOI:10.1001/jama.2015.8950 · 35.29 Impact Factor
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    ABSTRACT: Background Several lifestyle and environmental exposures have been suspected as risk factors for oral clefts, although few have been convincingly demonstrated. Studies across global diverse populations could offer additional insight given varying types and levels of exposures.Methods We performed an international case–control study in the Democratic Republic of the Congo (133 cases, 301 controls), Vietnam (75 cases, 158 controls), the Philippines (102 cases, 152 controls), and Honduras (120 cases, 143 controls). Mothers were recruited from hospitals and their exposures were collected from interviewer-administered questionnaires. We used logistic regression modeling to estimate odds ratios (OR) and 95% confidence intervals (CI).ResultsFamily history of clefts was strongly associated with increased risk (maternal: OR = 4.7; 95% CI, 3.0–7.2; paternal: OR = 10.5; 95% CI, 5.9–18.8; siblings: OR = 5.3; 95% CI, 1.4–19.9). Advanced maternal age (5 year OR = 1.2; 95% CI, 1.0–1.3), pregestational hypertension (OR = 2.6; 95% CI, 1.3–5.1), and gestational seizures (OR = 2.9; 95% CI, 1.1–7.4) were statistically significant risk factors. Lower maternal (secondary school OR = 1.6; 95% CI, 1.2–2.2; primary school OR = 2.4, 95% CI, 1.6–2.8) and paternal education (OR = 1.9; 95% CI, 1.4–2.5; and OR = 1.8; 95% CI, 1.1–2.9, respectively) and paternal tobacco smoking (OR = 1.5, 95% CI, 1.1–1.9) were associated with an increased risk. No other significant associations between maternal and paternal factors were found; some environmental factors including rural residency, indoor cooking with wood, chemicals and water source appeared to be associated with an increased risk in adjusted models.Conclusion Our study represents one of the first international studies investigating risk factors for clefts among multiethnic underserved populations. Our findings suggest a multifactorial etiology including both maternal and paternal factors. Birth Defects Research (Part A), 2015. © 2015 The Authors Birth Defects Research Part A: Clinical and Molecular Teratology Published by Wiley Periodicals, Inc.
    Birth Defects Research Part A Clinical and Molecular Teratology 08/2015; DOI:10.1002/bdra.23417 · 2.09 Impact Factor
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    Jonathan M. Samet · Dayana Chanson · Heather Wipfli
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    ABSTRACT: Research on active smoking and secondhand smoke exposure has led to policy changes to protect individuals from the adverse health impacts of tobacco smoke. Despite the extensive literature on tobacco, only recently has there been recognition that long-lived tobacco smoke components (known as “thirdhand smoke” or THS) in indoor environments where smoking has taken place may have adverse health consequences. This paper describes THS and addresses the challenges of limiting exposure to THS in vulnerable populations (e.g., nonsmokers and young children). We conducted a limited survey of key stakeholders in the Los Angeles area to better understand approaches to address THS in the real estate and automobile industries. Most respondents indicated concerns about past smoking for property value and reported using various techniques to eliminate THS. We consider examples of other pollutants as case studies, including radon, asbestos, and lead, to help frame policy directions for THS. Based on the information collected from stakeholders and the case studies, we offer policy approaches to managing THS.
    07/2015; 2(3):1-11. DOI:10.1007/s40572-015-0060-1
  • Yejin Mok · Dong-Koog Son · Young Duk Yun · Sun Ha Jee · Jonathan M Samet
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    ABSTRACT: Elevated serum γ-Glutamyltransferase (GGT) is a marker of hepatic injury and is associated with risk of chronic disease. However, the value of GGT as a biomarker for cancer risk remains unclear. Therefore, we evaluated the association of serum GGT with cancer incidence among more than 1.6 million Koreans. We included 1,662,087 Koreans (1,108,121 men and 553,966 women aged 20 to 95 years) who received health insurance from the National Health Insurance Service and had a biennial medical evaluation between 1995 and 1998. Follow-up was through December 2012. Using Cox proportional hazards models, we adjusted for age, smoking status, alcohol consumption, exercise, and body mass index after exclusion of early cases (cancer diagnosis or death within 5 years of starting follow-up) and estimated HRs of overall and organ-specific cancer incidence by GGT quintiles. During the 17-year follow-up, 129,087 new cancer cases occurred among the participants. Across levels of GGT, there was a positive gradient of HR and the highest quintile of GGT (≥60 IU/L) had the highest HR for all cancers in both men and women. By cancer site, the association was strongest for liver cancer, comparing the highest and lowest strata in men (HR, 6.67; 95% CI, 5.88-7.57) and in women (HR, 7.57; 95% CI, 6.41-8.94). Significant associations were also observed for cancers of the esophagus, larynx, stomach, colorectal, bile duct and lung in men, and of the bile duct in women. Increased serum GGT level is independently associated with risk of cancer. This article is protected by copyright. All rights reserved. © 2015 UICC.
    International Journal of Cancer 06/2015; DOI:10.1002/ijc.29659 · 5.09 Impact Factor
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    ABSTRACT: At least three factors may be driving the evolution of the vape shop industry, a rapidly growing market sector that specializes in the sales of electronic cigarettes: (1) the tobacco industry, (2) the public health sector and its diverse stakeholders, and (3) consumer demand. These influences and the responses of the vape shop sector have resulted in a rapidly changing landscape. This commentary briefly discusses these three factors and the implications for the health professions, as they address the vape shop industry and its consequences for public health. © The Author(s) 2015.
    Evaluation &amp the Health Professions 05/2015; DOI:10.1177/0163278715586295 · 1.91 Impact Factor
  • Jonathan M Samet
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    ABSTRACT: The Monograph program of the International Agency for Research on Cancer (IARC), which relies on the efforts of volunteer Working Groups, uses a transparent approach to evaluate the carcinogenicity of agents for which scoping has determined that there is sufficient evidence to warrant a review. Because of the potentially powerful implications of the conclusions of the Monographs and the sometimes challenging nature of the evidence reviewed, the monographs and the IARC process have been criticized from time to time. This commentary describes the IARC monograph process and addresses recent criticisms of the program, drawing on a recent defense of the program authored by 124 researchers. These authors concluded that the IARC processes are robust and transparent, and, not flawed and biased as suggested by some critics. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email:
    Carcinogenesis 05/2015; 36(7). DOI:10.1093/carcin/bgv062 · 5.33 Impact Factor
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    ABSTRACT: To identify macro-level trends that are changing the needs of epidemiologic research and practice and to develop and disseminate a set of competencies and recommendations for epidemiologic training that will be responsive to these changing needs. There were three stages to the project: (1) assembling of a working group of senior epidemiologists from multiple sectors, (2) identifying relevant literature, and (3) conducting key informant interviews with 15 experienced epidemiologists. Twelve macro trends were identified along with associated actions for the field and educational competencies. The macro trends include the following: (1) "Big Data" or informatics, (2) the changing health communication environment, (3) the Affordable Care Act or health care system reform, (4) shifting demographics, (5) globalization, (6) emerging high-throughput technologies (omics), (7) a greater focus on accountability, (8) privacy changes, (9) a greater focus on "upstream" causes of disease, (10) the emergence of translational sciences, (11) the growing centrality of team and transdisciplinary science, and (12) the evolving funding environment. Addressing these issues through curricular change is needed to allow the field of epidemiology to more fully reach and sustain its full potential to benefit population health and remain a scientific discipline that makes critical contributions toward ensuring clinical, social, and population health. Copyright © 2015 Elsevier Inc. All rights reserved.
    Annals of epidemiology 03/2015; 25(6). DOI:10.1016/j.annepidem.2015.03.002 · 2.00 Impact Factor
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    ABSTRACT: Recently the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also the approach used to perform these evaluations. Some critics have claimed that IARC Working Groups' failures to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans. The authors of this paper are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We have examined here criticisms of the IARC classification process to determine the validity of these concerns. We review the history of IARC evaluations and describe how the IARC evaluations are performed. We conclude that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various discipline and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed. The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.
    Environmental Health Perspectives 02/2015; 123(6). DOI:10.1289/ehp.1409149 · 7.98 Impact Factor
  • Junfeng Jim Zhang · Jonathan M Samet
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    ABSTRACT: Air pollution in many Chinese cities has been so severe in recent years that a special terminology, the "Chinese haze", was created to describe China's air quality problem. Historically, the problem of Chinese haze has developed several decades after Western high-income countries have significantly improved their air quality from the smog-laden days in the early- and mid-20(th) century. Hence it is important to provide a global and historical perspective to help China combat the current air pollution problems. In this regard, this article addresses the followings specific questions: (I) What is the Chinese haze in comparison with the sulfurous (London-type) smog and the photochemical (Los Angeles-type) smog? (II) How does Chinese haze fit into the current trend of global air pollution transition? (III) What are the major mitigation measures that have improved air quality in Western countries? and (IV) What specific recommendations for China can be derived from lessons and experiences from Western countries?
    Journal of Thoracic Disease 02/2015; 7(1):3-13. DOI:10.3978/j.issn.2072-1439.2014.12.06 · 1.78 Impact Factor
  • Yong S. Chung · Jonathan M. Samet
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    ABSTRACT: We began publication of our International Journal, Air Quality, Atmosphere & Health (AQAH) in 2008. Now, at the 8-year mark, we write to give you a progress report and to thank you for your support. We are pleased to announce that AQAH will now be published bi-monthly rather than quarterly, starting with the first issue of volume 8. This change reflects the large number of high-quality submissions and your support.Our journal has now achieved a key international standard. The Impact Factor (Thomson Reuters Journal Citation Reports®) of the AQAH was 1.979 in 2012 and 1.455 in 2013. We are delighted with this initial level of citation and will be taking every step possible to advance the recognition of the important articles that we are publishing. Presently, the rate of acceptance of all submitted manuscripts is 36 %, reflecting the proficiency and efficiency of the guidance from our reviewers. We are very much encouraged by these achievements in such a short period, and we must thank o ...
    Air Quality Atmosphere & Health 02/2015; 8(1). DOI:10.1007/s11869-015-0323-x · 1.80 Impact Factor
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    ABSTRACT: Time-series studies reporting associations between daily air pollution and health use pollution data from monitoring stations that vary in the frequency of recording. Within the Air Pollution and Health: A European and North American Approach (APHENA) project, we evaluated the impact of systematically missing daily measurements on the estimated effects of PM10 and ozone on daily mortality. For four cities with complete time-series data, we created patterns of systematically missing exposure measurements by deleting observations. Poisson regression-derived city-specific estimates were combined to produce overall effect estimates. Analyses based on incomplete time series gave considerably lower pooled PM10 and ozone health effects compared to those from complete data. City-specific estimates were generally lower although more variable. Systematically missing exposure data for air pollutants appears to lead to underestimation of associated health effects. Our findings indicate that the use of evidence from studies with incomplete exposure data may underestimate the impact of air pollution and highlight the advantage of having complete daily data in time-series studies.
    Air Quality Atmosphere & Health 12/2014; 7(4):415-420. DOI:10.1007/s11869-014-0250-2 · 1.80 Impact Factor
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    ABSTRACT: The International Agency for Research on Cancer recently classified outdoor air pollution and airborne particulate matter as carcinogenic to humans. However, there are gaps in the epidemiologic literature, including assessment of possible joint effects of cigarette smoking and fine particulate matter (particulate matter less than or equal to 2.5 µm in diameter) on lung cancer risk. We present estimates of interaction on the additive scale between these risk factors from Cancer Prevention Study II, a large prospective US cohort study of nearly 1.2 million participants recruited in 1982. Estimates of the relative excess risk of lung cancer mortality due to interaction, the attributable proportion due to interaction, and the synergy index were 2.19 (95% confidence interval (CI): -0.10, 4.83), 0.14 (95% CI: 0.00, 0.25), and 1.17 (95% CI: 1.00, 1.37), respectively, using the 25th and 75th percentiles as cutpoints for fine particulate matter. This suggests small increases in lung cancer risk among persons with both exposures beyond what would be expected from the sum of the effects of the individual exposures alone. Although reductions in cigarette smoking will achieve the greatest impact on lung cancer rates, these results suggest that attempted reductions in lung cancer risk through both tobacco control and air quality management may exceed expectations based on reducing exposure to either risk factor alone.
    American Journal of Epidemiology 11/2014; 180(12). DOI:10.1093/aje/kwu275 · 5.23 Impact Factor
  • JAMA The Journal of the American Medical Association 11/2014; 312(23). DOI:10.1001/jama.2014.14830 · 35.29 Impact Factor
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    Jonathan M. Samet · Ross C. Brownson
    American Journal of Preventive Medicine 11/2014; 47(5):S383–S385. DOI:10.1016/j.amepre.2014.07.012 · 4.53 Impact Factor
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    Jonathan M Samet · Sofia Gruskin
    The Lancet Respiratory Medicine 10/2014; 3(2). DOI:10.1016/S2213-2600(14)70145-6 · 9.63 Impact Factor
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    ABSTRACT: Genome-wide association studies (GWAS) for orofacial clefts have identified several susceptibility regions, but have largely focused on non-Hispanic White populations in developed countries. We performed a targeted genome-wide study of single nucleotide polymorphisms (SNPs) in exons using the Illumina HumanExome+ array with custom fine mapping of 16 cleft susceptibility regions in three underserved populations: Congolese (87 case-mother, 210 control-mother pairs), Vietnamese (131 case-parent trios), and Filipinos (42 case-mother, 99 control-mother pairs). All cases were children with cleft lip with or without cleft palate. Families were recruited from local hospitals and parental exposures were collected using interviewer-administered questionnaires. We used logistic regression models for case-control analyses, family-based association tests for trios, and fixed-effect meta-analyses to determine individual SNP effects corrected for multiple testing. Of the 16 known susceptibility regions tested, SNPs in four regions reached statistical significance in one or more of these populations: 1q32.2 (IRF6), 10q25.3 (VAX1), and 17q22 (NOG). Due to different linkage disequilibrium patterns, significant SNPs in these regions differed between the Vietnamese and Filipino populations from the index SNP selected from previous GWAS studies. Among Africans, there were no significant associations identified for any of the susceptibility regions. rs10787738 near VAX1 (P = 4.98E−3) and rs7987165 (P = 6.1E−6) were significant in the meta-analysis of all three populations combined. These results confirm several known susceptibility regions and identify novel risk alleles in understudied populations. © 2014 Wiley Periodicals, Inc.
    American Journal of Medical Genetics Part A 10/2014; 164A(10). DOI:10.1002/ajmg.a.36693 · 2.16 Impact Factor
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    Jonathan M. Samet
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    ABSTRACT: Engineered nanomaterials have structured components less than 100 nanometers or 0.1 μm in greatest diameter. Products with nanomaterials as their basis are diverse, including diagnostic and therapeutic agents, stain-resistant clothing, solar cells, sun blocks, and cosmetics, and an expanding array of applications is anticipated. The increasing production and use of engineered nanomaterials may lead to greater exposures of workers, consumers, and the environment, and raises concerns about potential harms to human and ecosystem health. This paper addresses the general topic of research on engineered nanomaterials, health, and the environment. It covers the history of research planning on engineered nanomaterials, giving emphasis to the recent reports from a committee of the US National Research Council. The two reports from this committee offered a framework-based research strategy intended to address critical uncertainties. This paper ends with general lessons learned from experience with engineered nanomaterials that may apply to other emerging environmental threats.
    09/2014; 1(3). DOI:10.1007/s40572-014-0023-y
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    ABSTRACT: Implementation Science is a set of tools, principles and methodologies that can be used to bring scientific evidence into action, improve health care quality and delivery and improve public health. As the burden of cancer increases in low- and middle-income countries, it is important to plan cancer control programs that are both evidence-based and delivered in ways that are feasible, cost-effective, contextually appropriate and sustainable. This review presents a framework for using implementation science for cancer control planning and implementation and discusses potential areas of focus for research and programs in low and middle-income countries interested in integrating research into practice and policy.
    Cancer Epidemiology Biomarkers & Prevention 09/2014; 23(11). DOI:10.1158/1055-9965.EPI-14-0472 · 4.13 Impact Factor
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    ABSTRACT: While hair samples are easier to collect and less expensive to store and transport than biological fluids, and hair nicotine characterizes tobacco exposure over a longer time period than blood or urine cotinine, information on its utility, compared with salivary cotinine, is still limited. We conducted a cross-sectional study with 289 participants (107 active smokers, 105 passive smokers with self-reported secondhand smoke (SHS) exposure, and 77 non-smokers with no SHS exposure) in Baltimore (Maryland, USA). A subset of the study participants (n = 52) were followed longitudinally over a two-month interval. Median baseline hair nicotine concentrations for active, passive and non-smokers were 16.2, 0.36, and 0.23 ng/mg, respectively, while those for salivary cotinine were 181.0, 0.27, and 0.27 ng/mL, respectively. Hair nicotine concentrations for 10% of passive or non-smokers were higher than the 25th percentile value for active smokers while all corresponding salivary cotinine concentrations for them were lower than the value for active smokers. This study showed that hair nicotine concentration values could be used to distinguish active or heavy passive adult smokers from non-SHS exposed non-smokers. Our results indicate that hair nicotine is a useful biomarker for the assessment of long-term exposure to tobacco smoke.
    International Journal of Environmental Research and Public Health 08/2014; 11(8):8368-8382. DOI:10.3390/ijerph110808368 · 2.06 Impact Factor

Publication Stats

28k Citations
3,557.45 Total Impact Points


  • 2015
    • Duke University
      Durham, North Carolina, United States
  • 2009–2015
    • Keck School of Medicine USC
      Los Ángeles, California, United States
    • University of Southern California
      • • Department of Preventive Medicine
      • • Keck School of Medicine
      Los Ángeles, California, United States
  • 2009–2014
    • University of California, Los Angeles
      Los Ángeles, California, United States
  • 1996–2012
    • Johns Hopkins Bloomberg School of Public Health
      • • Department of Epidemiology
      • • Department of Biostatistics
      Baltimore, Maryland, United States
  • 1995–2012
    • Johns Hopkins University
      • • Department of Epidemiology
      • • Department of Biostatistics
      Baltimore, Maryland, United States
    • University of Adelaide
      Tarndarnya, South Australia, Australia
  • 1979–2012
    • University of New Mexico
      • • Division of Hospital Medicine
      • • School of Medicine
      Albuquerque, New Mexico, United States
  • 2011
    • San Francisco VA Medical Center
      San Francisco, California, United States
  • 2005–2009
    • Yonsei University
      • Graduate School of Public Health
      Seoul, Seoul, South Korea
  • 2004–2009
    • Yale University
      • School of Forestry and Environmental Studies
      New Haven, CT, United States
    • University of Florida
      • Department of Statistics
      Gainesville, FL, United States
  • 2007
    • University of Ottawa
      Ottawa, Ontario, Canada
    • Baltimore City Public Schools
      Baltimore, Maryland, United States
    • University of Rochester
      • Division of General Medicine
      Rochester, New York, United States
  • 2006
    • Boston College, USA
      Boston, Massachusetts, United States
    • University of California, San Francisco
      San Francisco, California, United States
  • 1997–2006
    • United States Environmental Protection Agency
      Corvallis, Oregon, United States
    • University of Maryland, Baltimore
      • Department of Epidemiology and Public Health
      Baltimore, Maryland, United States
  • 1982–2004
    • University of New Mexico Hospitals
      Albuquerque, New Mexico, United States
  • 2002
    • Boston University
      Boston, Massachusetts, United States
  • 2001
    • University of Minnesota Duluth
      Duluth, Minnesota, United States
  • 1997–2000
    • University of North Carolina at Chapel Hill
      • Center for Environmental Medicine, Asthma and Lung Biology
      North Carolina, United States
  • 1999
    • Wake Forest School of Medicine
      • Department of Internal Medicine
      Winston-Salem, NC, United States
  • 1998
    • University of Alabama at Birmingham
      Birmingham, Alabama, United States
  • 1994
    • Albuquerque Academy
      Albuquerque, New Mexico, United States
  • 1984–1987
    • Brigham and Women's Hospital
      • Department of Medicine
      Boston, Massachusetts, United States