Environmental Health Commons^™

Exposure To Pm2.5 And Aging., Daniel Chris Gomes

Electronic Theses and Dissertations

Inhalation of fine airborne particulate matter (PM_2.5) is an environmental risk factor for numerous health disorders, including cardiovascular diseases (CVD). While several studies have shown that PM_2.5 exposure can induce oxidative stress, DNA damage, and inflammation, the underlying mechanisms that translate these effects into systemic pathology remain poorly understood. Some recent studies have shown that PM_2.5 exposure can lead to telomere shortening in leukocytes, but the generality of this outcome and contribution to endothelial dysfunction has not yet been fully explored. We hypothesized that PM_2.5inhalation accelerates cellular aging and senescence in both circulating peripheral …

Analysis Of An Ethanol Sensitive Bmp-Nkx2.3-Fgf Signaling Pathway In Pouch Morphogenesis., Hieu Dai Le Vo

Electronic Theses and Dissertations

Craniofacial malformations lie at the heart of Fetal Alcohol Spectrum Disorders (FASD). While there is growing evidence for a genetic component to FASD, little is known of the cellular mechanisms underlying these ethanol-sensitive loci in facial development. Bone Morphogenetic Protein (Bmp) signaling pathway dependent pouch formation is a key mechanism in facial development. We have previously shown that multiple Bmp mutants are sensitized to ethanol-induced facial defects. However, ethanol does not directly impact Bmp signaling. This suggests that downstream effectors, like nkx2.3 and Fibroblast Growth Factor (Fgf) signaling, may mediate the impact of ethanol on Bmp mutants. Here, I …

Translation Of The Carcinogenic Dna Breakage-Repair Inhibition Mechanism For Hexavalent Chromium To Its Key Targets: Lung Epithelial Cells, Lung Tissue And Impacts On The Genome., Idoia Meaza Isusi

Electronic Theses and Dissertations

Lung cancer is the leading cause of cancer death worldwide. Hexavalent chromium [Cr(VI)] is a human lung carcinogen with widespread occupational and environmental exposure. Despite the known health risks, how Cr(VI) causes lung cancer remains unclear. This dissertation investigates the mechanisms of Cr(VI)-induced carcinogenesis. Cr(VI) causes DNA damage, specifically DNA double strand breaks, and inhibits homologous recombination repair, a high-fidelity repair pathway. Unrepaired DNA double strand breaks or those repaired through error-prone pathways, progress to chromosomal damage, and chromosome instability. The latter is a common characteristic of Cr(VI)-exposed cells, and a hallmark of lung cancer. Although the mechanism of Cr(VI)-induced …

Anti-Aging Properties Of Cosmetics, Anna Lipinski

The Cardinal Edge

It is well established that external factors, specifically UV exposure, are among the highest contributors to the biological aging of the skin. Prolonged exposure may disrupt skin cell homeostasis through shifts in proteostasis, accumulation of reactive oxidative species, premature cellular senescence, and inflammatory pathways. Cosmetic companies have responded to this by producing products marketed as "youthful" and "anti-aging" by including specific compounds into formulas to combat skin aging. This review discusses the specific mechanisms of anti-aging formulas, including polyphenols as senotherapeutic agents and L-ascorbic acid as an anti-inflammatory compound, in resisting the biological aging of the skin.

Anthropogenic Litter In Urban Waterways: An Analysis Of Litter, Urbanization, And The Emerging Role Of Citizen Science In Beargrass Creek, Louisville, Ky., Ella Swigler

Electronic Theses and Dissertations

This thesis addressed the ever growing presence and persistence of anthropogenic litter (AL) in urban waterways. AL has been studied in marine environments, but research gaps exist in riverine ecosystems. Most of the AL that reaches the Earth’s oceans is carried by urban rivers, so understanding the relationship between these waterways and AL is critical in effectively fighting AL accumulation, especially for legacy plastic pollutants. The study explored fifteen sites throughout Beargrass Creek and recorded the quantity and type of AL present throughout the summer and fall of 2023. The National Geographic Marine Debris Tracker App was employed to successfully …

Using A Toxic Aging Coin To Assess Hexavalent Chromium-Induced Neurotoxicity., Samuel Thomas Vielee

Electronic Theses and Dissertations

We are facing an aging crisis, with 20% of the U.S. population projected to be geriatric (65+) by 2030 and live another 40+ years. Age-related diseases accompany a growing geriatric population, emphasizing the need to understand their etiology. Environmental pollutants compound this crisis by: 1) geriatrics are more susceptible, exacerbating age-related diseases and comorbidities, and 2) they accelerate biological aging, inducing age-related diseases at younger ages. We address this crisis using a ‘toxic aging coin’ approach; heads examines how age impacts toxicity, tails examines how chemicals accelerate aging. This thesis applies the heads side for Cr(VI)-induced neurotoxicity across ages. We …

Effects Of Environmental Pollutants On Liver Disease: Role Of The Gut-Liver Axis., Ngozi Victoria Adiele

Electronic Theses and Dissertations

Polychlorinated biphenyls (PCBs) and polystyrene (PS) microplastics are environmental pollutants associated with various diseases including toxicant associated fatty liver disease (TAFLD). Previously, exposure to Aroclor 1260 (a PCB mixture) has been shown to exacerbate TAFLD, partly through Aroclor 1260 induced gut dysbiosis. Studies has also demonstrated that PS exposure alters gut microbiome composition and induced obesity. However, the effects of Aroclor 1260 on the gut and the effects of PS on the liver are still understudied. Therefore, we hypothesize that environmental pollutants will disrupt the gut-liver axis through changes in gut and its microbiome as well as changes in liver …

The Role Of E-Liquid Constituents In E-Cigarette-Induced Cardiac Arrhythmia And Autonomic Imbalance., Cory Kucera

Electronic Theses and Dissertations

Introduction. Accumulating evidence indicates that exposure to electronic cigarettes (e-cigs) promotes sympathetic dominance and electrophysiologic instability in the heart, potentially culminating in arrhythmogenesis. E-liquids contain various formulations of nicotine and flavorings, but the effects of specific e-liquid constituents and their concentrations on e-cig-induced autonomic imbalance and electrical dysfunction are unresolved. To that end, we tested the hypothesis that e-cigs modify cardiac autonomic balance and ventricular arrhythmogenesis in mice dependent on e-liquid constituent type and concentration. Methods. Using a crossover design and a serial exposure regimen, ECG-telemetered male C57BL/6J mice underwent whole-body exposure to e-cig aerosols generated from e-liquids containing different …

The Effect Of Volatile Organic Compounds On Endothelial Function And Atherogenesis., Samantha Mcfall

Electronic Theses and Dissertations

Volatile organic compounds (VOCs) are a group of pervasive air pollutants that are released into the atmosphere from both anthropogenic and environmental sources. Recent epidemiological studies suggest that exposure to various VOCs is associated with an increased risk of cardiovascular disease. However, the relationship between VOCs and cardiovascular disease is not well-studied. Using animal models and three select VOCs, benzene, xylene, and trichloroethylene, we studied the effects of VOCs on endothelial injury and benzene-induced atherogenesis. We found that exposure to benzene and xylene increased circulating endothelial microparticles, depleted progenitor cells, and increased platelet activation. Following the exposure to the representative …

Wastewater-Informed Public Health Intervention Playbook

Sustain Magazine

As the SARS-CoV-2 pandemic quickly spread from country to country and continent to continent in 2020, governments and scientists needed a way to track COVID-19 through populations in order to position public health interventions in the most impactful locations. Having a decision-based risk framework may help to guide policy creation that could minimize or prevent possible outbreaks and surges of infection within communities. The University of Louisville in partnership with Louisville’s Department of Public Health and Wellness tested this strategy in 2021 and 2022. This Wastewater-Informed Public Health Intervention Playbook describes the decisions and actions of that academic and public …

An Interdisciplinary Discussion On Climate Change, Aamira Shah, Jaley F. Adkins, Kelsey Littrell, Priyadarshini Chandrashekhar

The Cardinal Edge

No abstract provided.

Implementation Of A Drive-Through Covid-19 Mass Vaccination Site: Experiences From Louvax–Broadbent In Louisville, Kentucky, Ruth Carrico, Sarah Beth Hartlage, Valenchia Brown Msn, Aprn, Fnp-C, Sarah M. Bishop, Luanne Didelot, William Hayden, Beverly Williams Coleman, Sarah Tan, Delanor Manson, Kellie Kane, Dawn Balcom, Paul Kern

The University of Louisville Journal of Respiratory Infections

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination.

Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked …

Surveillance Of Rnase P, Pmmov, And Crassphage In Wastewater As Indicators Of Human Fecal Concentration Across Urban Sewer Neighborhoods, Louisville, Kentucky., R. H. Holm, M. Nagarkar, R. A. Yeager, D. Talley, A. C. Chaney, J. P. Rai, A. Mukherjee, S. N. Rai, A. Bhatnagar, T. Smith

Faculty and Staff Scholarship

Wastewater surveillance has been widely used as a supplemental method to track the community infection levels of severe acute respiratory syndrome coronavirus 2. A gap exists in standardized reporting for fecal indicator concentrations, which can be used to calibrate the primary outcome concentrations from wastewater monitoring for use in epidemiological models. To address this, measurements of fecal indicator concentration among wastewater samples collected from sewers and treatment centers in four counties of Kentucky (N = 650) were examined. Results from the untransformed wastewater data over 4 months of sampling indicated that the fecal indicator concentration of human ribonuclease P (RNase …

Combining Community Wastewater Genomic Surveillance With State Clinical Surveillance: A Framework For Sars-Cov-2 Public Health Practice., Ted Smith, Rochelle H. Holm, Ray Yeager, Joseph B. Moore Iv, Eric C. Rouchka, Kevin J. Sokoloski, Daymond Talley, Vaneet Arora, Sarah Moyer, Aruni Bhatnagar

Faculty and Staff Scholarship

Study objective: To garner a framework for combining community wastewater surveillance with state clinical surveillance that influence confirmation of SARS-CoV-2 variants within the community, and recommend how the flow of such research evidence could be expanded and employed for public health response. Design, setting, and participants: This work involved analyzing wastewater samples collected weekly from 17 geographically resolved locations in Louisville/Jefferson County, Kentucky from February 10 to November 29, 2021. Genomic surveillance and RT-qPCR platforms were used as screening to identify SARS-CoV-2 in wastewater, and state clinical surveillance was used for confirmation. Main results: The results demonstrate increased epidemiological value …

Public Awareness And Support For Use Of Wastewater For Sars-Cov-2 Monitoring: A Community Survey In Louisville, Kentucky., Rochelle H. Holm, J. Michael Brick, Alok R. Amraotkar, Joy L. Hart, Anish Mukherjee, Jacob Zeigler, Adrienne M. Bushau-Sprinkle, Lauren B. Anderson, Kandi L. Walker, Daymond Talley, Rachel J. Keith, Shesh N. Rai, Kenneth E. Palmer, Aruni Bhatnagar, Ted Smith

Faculty and Staff Scholarship

The majority of sewer systems in the United States and other countries, are operated by public utilities. In the absence of any regulation, public perception of monitoring wastewater for population health biomarkers is an important consideration for a public utility commission when allocating resources for this purpose. In August 2021, we conducted a survey as part of an ongoing COVID-19 community prevalence study in Louisville/Jefferson County, KY. The survey comprised of seven questions about awareness of and privacy concerns and was sent to 32,000 households randomly distributed within the county. A total of 1,220 sampled adults participated in the probability …

High-Throughput Sequencing Of Sars-Cov-2 In Wastewater Provides Insights Into Circulating Variants., Rafaela S. Fontenele, Simona Kraberger, James Hadfield, Erin M. Driver, Devin Bowes, La Rinda A. Holland, Temitope O.C. Faleye, Sangeet Adhikari, Rahul Kumar, Rosa Inchausti, Wydale K. Holmes, Stephanie Deitrick, Philip Brown, Darrell Duty, Ted Smith, Aruni Bhatnagar, Ray A. Yeager, Rochelle H. Holm, Natalia Hoogesteijn Von Reitzenstein, Elliott Wheeler, Kevin Dixon, Tim Constantine, Melissa A. Wilson, Efrem S. Lim, Xiaofang Jiang, Rolf U. Halden, Matthew Scotch, Arvind Varsani

Faculty and Staff Scholarship

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) likely emerged from a zoonotic spill-over event and has led to a global pandemic. The public health response has been predominantly informed by surveillance of symptomatic individuals and contact tracing, with quarantine, and other preventive measures have then been applied to mitigate further spread. Non-traditional methods of surveillance such as genomic epidemiology and wastewater-based epidemiology (WBE) have also been leveraged during this pandemic. Genomic epidemiology uses high-throughput sequencing of SARS-CoV-2 genomes to inform local and international transmission events, as well as the diversity of circulating variants. WBE uses wastewater to analyse community spread, …

The Rapid Assessment Of Aggregated Wastewater Samples For Genomic Surveillance Of Sars-Cov-2 On A City-Wide Scale., Eric C. Rouchka, Julia H. Chariker, Kumar Saurabh, Sabine Waigel, Wolfgang Zacharias, Mei Zhang, Daymond Talley, Ian Santisteban, Madeline Puccio, Sarah Moyer, Rochelle H. Holm, Ray A. Yeager, Kevin J. Sokoloski, Joshua Fuqua, Aruni Bhatnagar, Ted Smith

Faculty and Staff Scholarship

Throughout the course of the ongoing SARS-CoV-2 pandemic there has been a need for approaches that enable rapid monitoring of public health using an unbiased and minimally invasive means. A major way this has been accomplished is through the regular assessment of wastewater samples by qRT-PCR to detect the prevalence of viral nucleic acid with respect to time and location. Further expansion of SARS-CoV-2 wastewater monitoring efforts to include the detection of variants of interest/concern through next-generation sequencing has enhanced the understanding of the SARS-CoV-2 outbreak. In this report, we detail the results of a collaborative effort between public health …

Novel Pilot Development Of A Closed-Loop Sustainable System Between Biogas Renewable Energy, Distilling, And Aquaculture By Vermiculture Of Stillage Wastes, Samuel C. Kessler

The Cardinal Edge

This study provides a mixed-methods approach in analyzing a potential closed-loop system between renewable biogas production from anaerobic digestion, vermiculture production, aquaculture production, and organic wastes with a particular focus on stillage wastes. Such system may hold significant promise for significantly reducing organic carbon and methane emissions from its components, and should be assessed for such. The 2021 IPCC report essentially identified methane reduction as the single fastest way to slow global warming (IPCC, 2021), making the study and implementation of methane-reducing systems and supportive policy for them critical. Knowledge gaps to implementing this system were qualitatively identified as disconnect …

Standardizing Data Reporting In The Research Community To Enhance The Utility Of Open Data For Sars-Cov-2 Wastewater Surveillance., Jill S. Mcclary-Gutierrez, Zachary T. Aanderud, Mitham Al-Faliti, Claire Duvallet, Raul Gonzalez, Joe Guzman, Rochelle H. Holm, Michael A. Jahne, Rose S. Kantor, Panagis Katsivelis, Katrin Gaardbo Kuhn, Laura M. Langan, Cresten Mansfeldt, Sandra L. Mclellan, Lorelay M. Mendoza Grijalva, Kevin S. Murnane, Colleen C. Naughton, Aaron I. Packman, Sotirios Paraskevopoulos, Tyler S. Radniecki, Fernando A. Roman, Abhilasha Shrestha, Lauren B. Stadler, Joshua A. Steele, Brian M. Swalla, Peter Vikesland, Brian Wartell, Carol J. Wilusz, Judith Chui Ching Wong, Alexandria B. Boehm, Rolf U. Halden, Kyle Bibby, Jeseth Delgado Vela

Faculty and Staff Scholarship

SARS-CoV-2 RNA detection in wastewater is being rapidly developed and adopted as a public health monitoring tool worldwide. With wastewater surveillance programs being implemented across many different scales and by many different stakeholders, it is critical that data collected and shared are accompanied by an appropriate minimal amount of meta-information to enable meaningful interpretation and use of this new information source and intercomparison across datasets. While some databases are being developed for specific surveillance programs locally, regionally, nationally, and internationally, common globally-adopted data standards have not yet been established within the research community. Establishing such standards will require national and …

Investigating The Effects Of Perfluorooctanoic Sulfonate (Pfos) And Ethanol On Fatty Liver Disease Using A Modified Niaaa Model., Tyler Charles Gripshover

Electronic Theses and Dissertations

Perfluoroalkyl Substances (PFAS) are a family of man-made, surfactant-like compounds that are a major environmental contaminant. A multitude of studies have indicated that PFAS are able to induce fatty liver disease and modulate lipid metabolism. However, the distinct mechanism of PFAS influence on the liver and metabolism disruption remains to be elucidated. On the other hand, it is well documented that alcohol consumption has various adverse health impacts including fatty liver disease and subsequent progression to more adverse liver states. To date, there are no published studies on whether PFAS and alcohol can jointly exacerbate fatty liver progression or interact …

Geographic And Occupational Mobility Of Small-Scale Fishers Of Lake Malawi: An Exploratory Study Of Water, Sanitation, And Hygiene Access, Malawi., Rochelle H. Holm, Tikhala Chakalamba, Bwighane Ngasama, Fanuel Kapute

Faculty and Staff Scholarship

The livelihood of small-scale fishers on the world’s freshwater lakes cuts across the Sustainable Development Goal (SDG) 6, which covers water and sanitation, and SDG 8 on economic growth. The aim of this study was to examine the nature and extent of fishers’ mobility patterns and access to improved sanitation facilities, safe drinking water, and handwashing practices while at work and home for two fishing camps in Malawi. The study used key informant interviews, questionnaires, water quality testing, and an observational checklist, followed by interviews on fishers’ occupational migration. Many fishers (85%; 51/60) live and work in fishing camps with …

Wastewater Sample Site Selection To Estimate Geographically Resolved Community Prevalence Of Covid-19: A Sampling Protocol Perspective., R. Yeager, R. H. Holm, K. Saurabh, J. L. Fuqua, D. Talley, A. Bhatnagar, T. Smith

Faculty and Staff Scholarship

Wastewater monitoring for virus infections within communities can complement conventional clinical surveillance. Currently, most SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) clinical testing is voluntary and inconsistently available, except for a few occupational and educational settings, and therefore likely underrepresents actual population prevalence. Randomized testing on a regular basis to estimate accurate population-level infection rates is prohibitively costly and is hampered by a range of limitations and barriers associated with participation in clinical research. In comparison, community-level fecal monitoring can be performed through wastewater surveillance to effectively surveil communities. However, epidemiologically defined protocols for wastewater sample site selection are lacking. …

Assessing The Role Of Chronic Arsenite Exposure In Disrupting The Egfr Signaling Axis., Christine Kim

Electronic Theses and Dissertations

Chronic arsenic exposure is a risk factor for the development of pulmonary diseases, including lung cancer, but the exact mechanism is not yet fully understood. Many previous studies have relied on acute arsenic exposure (i.e. 1-10 uM arsenic for 24 hours) to study arsenic toxicological effects. However, acute exposure does not reflect the levels or duration of arsenic associated with environmental exposure, or drinking of contaminated well water. This dissertation differentiates the effects of acute versus chronic arsenic exposures on the EGFR signaling axis and suggests possible mechanisms for chronic arsenic-induced pulmonary diseases. The EGFR is a receptor tyrosine kinase …

Identifying The Cardiovascular Effects Of Multiple Pollutants., Katlyn Elizabeth Mcgraw

Electronic Theses and Dissertations

Cardiovascular disease (CVD) is the leading cause of death from environmental exposures. Although exposure to PM_2.5 is an established risk factor for CVD, the contribution of other hazardous pollutant exposure to CVD is less clear. Overall, this work aimed to examine the effect of pollutants with lesser documented effects on cardiovascular disease using a multi-pronged approach to exposure assessment. The three aims were to examine the relationship between county-level toxic chemical releases and CVD mortality in the contiguous United States between 2002 and 2012, to assess the relationship between individual-level VOC metabolites and vascular function, and to build multipollutant …

Impact Of Sampling Depth On Pathogen Detection In Pit Latrines., Drew Capone, Petros Chigwechokha, Francis L. De Los Reyes, Rochelle H. Holm, Benjamin B. Risk, Elizabeth Tilley, Joe Brown

Faculty and Staff Scholarship

Wastewater based epidemiology (WBE) is increasingly used to provide decision makers with actionable data about community health. WBE efforts to date have primarily focused on sewer-transported wastewater in high-income countries, but at least 1.8 billion people in low-and middle-income countries (LMIC) use onsite sanitation systems such as pit latrines and septic tanks. Like wastewater, fecal sludges from such systems offer similar advantages in community pathogen monitoring and other epidemiological applications. To evaluate the distribution of enteric pathogens inside pit latrines–which could inform sampling methods for WBE in LMIC settings unserved by sewers–we collected fecal sludges from the surface, mid-point, and …

How A Low-Cost Method For Cumulative Water-Sampling Shows Need For Improvement Of Legal Public-Contact Standards In The United States, Samuel C. Kessler

Grawemeyer Colloquium Papers

Across the world, it is estimated that 4.5 billion people live near water sources “impaired” for use or contact. Standards for human-interaction are established by international organizations such as the WHO, and legislative bodies from national to local levels with jurisdiction over the quality of our waterways to ensure public & environmental health. Standards are often assessed from “grab-samples” taken from a waterbody at a certain time, with a minimum number analyzed. Water-quality standards in the United States are enforced under the Clean Water Act (CWA) via the Environmental Protection Agency (EPA), applying to “waters of the United States” (WOTUS). …

A Qualitative Study Of Nimbyism For Waste In Smaller Urban Areas Of A Low-Income Country, Mzuzu, Malawi., Rochelle H. Holm, Brighton A. Chunga, Adrian Mallory, Paul Hutchings, Alison Parker

Faculty and Staff Scholarship

When waste management infrastructure is built, there can be resistance from the local affected populations, often termed the Not in My Backyard (NIMBY) phenomenon. This study aims to understand the forms of resistance that may develop in such contexts, focusing on 2 solid waste and 1 liquid waste management site within Mzuzu City, Malawi. At the newest solid waste site, community resistance had grown to the extent that the site was reportedly destroyed by the local community. Interviews and observations of the sites are complemented by examining historic and recent satellite images. It was found that, at the new solid …

A Review Of The Financial Value Of Faecal Sludge Reuse In Low-Income Countries., Adrian Mallory, Rochelle Holm, Alison Parker

Faculty and Staff Scholarship

Faecal sludge reuse could promote responsible waste management and alleviate resource shortages. However, for this reuse to be carried out at scale, it needs to be financially viable. This paper reviews the financial values of resource recovery from 112 data points from 43 publications from academic and grey literature. The results found 65% of the existing literature is projected rather than being based on observed data from products in practice, with limited studies providing actual experiences of revenue in practice. Some of the estimates of the potential value were ten times those observed in data from operating businesses. Reasons for …

Re-Evaluating The Strength Of Pit-Latrine Faecal Sludge From Dynamic Cone Penetrometer Test Data., Yasmine Shafiq, Stuart Haigh, Rochelle Holm, Alison Parker

Faculty and Staff Scholarship

In 2017, 55% of the global population were without safely managed sanitation services. On-site sanitation solutions, such as pit latrines, provide the majority of sanitation coverage across developing countries. Appropriate technologies are required in order to safely empty these latrines without damage to people or the environment. The design of appropriate emptying technologies can be hampered by a lack of knowledge of the mechanical properties of the waste, such as its strength. This paper will develop a calibration for a dynamic cone penetrometer to give accurate measurements of faecal sludge strength against a standard scale, rendering existing data comparable. It …

Tobacco Product-Derived Aldehydes: Effects On Circulating Angiogenic Cells & Implications For Cardiovascular Disease., Jordan B. Lynch

Electronic Theses and Dissertations

Cardiovascular disease (CVD) is the leading cause of death worldwide. Tobacco smoke is the most significant modifiable risk factor in CVD development and contains numerous toxic compounds, including aldehydes, which have been linked to CVD. Formaldehyde, acetaldehyde, acrolein, and crotonaldehyde have been identified as significant contributors to cigarette-induced health effects, but the mechanism of these effects is not well understood. These aldehydes are also found in aerosols produced by e-cigarettes (e-cigs). The goal of this dissertation was to explore the systemic, hematological, and endothelium-related effects of exposure to tobacco products and constituent aldehydes and to identify potential mechanisms of injury. …