Disorders of Environmental Origin Commons^™

From Combustion Emissions To Neurotoxicity: Brain Health Risks Of Military Burn Pits Exposure, Katherine M. Eggers, Zoe A. Keller, Paul Barach, Julie M. Tomáška, Joshua P. Nixon, Janeen H. Trembley, Tammy A. Butterick

College of Population Health Faculty Papers

Military burn pits used during post-9/11 U.S. military deployments functioned as uncontrolled combustion systems and were widely utilized to dispose of large volumes of outdoor waste by burning. Burn pits involved heterogeneous waste materials burned under variable temperature and oxygen conditions. These combustion environments generated complex, toxic, multipollutant airborne emission mixtures that included particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). This narrative review synthesizes epidemiologic, experimental, and mechanistic evidence linking burn pit emissions to disruption of the lung–brain axis and adverse neurological outcomes. We specifically aim to address a critical gap in understanding how combustion-derived …

Projected U.S. Cardiovascular Disease Burden From Heat Exposure For Future Greenhouse Gas Scenarios, Gokul Parmeswaran, Sai Rahul Ponnana, Santosh Kumar Sirasapalli, Niketh Surya, Tong Zhang, Zhuo Chen, Jean-Eudes Dazard, Salil V. Deo, Sanjay Rajagopalan

Faculty Scholarship

Importance: Climate change may reverse decades of improvements in cardiovascular disease (CVD) mortality in the US; however, comprehensive regional projections of heat-related CVD burden in the US are unavailable. Objective: To use the county-level observed (2010-2016) heat-related CVD burden in the US to obtain the projected rates through 2050 according to the mean (shared socioeconomic pathway [SSP] 2-4.5) and high (SSP5-8.5) greenhouse gas (GHG) emission pathways. Design, Setting, and Participants: This cross-sectional ecological analysis used county-level summary data including all counties in the contiguous US from 2010 through 2016 as baseline data with projections to 2030 and 2050 under SSP …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

Training Vs. Reality: The Challenges Of Preventing Heat-Related Illness In Migrant Farmworkers, Sonya Homami

Rowan-Virtua Research Day

Background: Heat‑Related Illness (HRI) is a major occupational hazard for migrant farmworkers, who are 35 times more likely to die from HRI than workers in other industries. Although HRI training aims to improve prevention knowledge, its effect on actual HRI outcomes is unclear.

Methods: Following PRISMA guidelines, a systematic review of PubMed, Embase, and Web of Science identified studies evaluating HRI training and reporting HRI prevalence or related symptoms. Fifteen studies met inclusion criteria.

Results: HRI training did not reduce HRI prevalence or provide protective effects. Training increased reporting of workplace injuries and concern about HRI. Despite high training uptake—over …

Wildfires And Emergency Department Respiratory Surge: Brief Review, Systems Forecasting Implications And Recommendations For Research, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Wildfire smoke produces abrupt increases in PM2.5 and Air Quality Index (AQI) levels. Event-based and multi-season studies demonstrate short-term increases in asthma-related Emergency Department (ED) visits, with additional evidence supporting increased utilization for broader respiratory disease and chronic lower respiratory disease (including COPD) (Reid et al., 2016; Liu et al., 2015; Stowell et al., 2025; CDC, 2023).

Objective: To synthesize current evidence linking wildfire smoke to ED respiratory surge and to propose a systems forecasting model that translates environmental signals into structured operational stabilization within a complex adaptive system (CAS).

Methods (Review & Model Development): Narrative synthesis of event-based …

Examining The Association Between Ddt Exposure And Parkinson’S Disease, Hodges Mccathern

Undergraduate Honors Theses

Dichlorodiphenyltrichloroethane, commonly known as DDT, was an organochlorine pesticide widely used in the mid-20th century. It is highly stable and resistant to degradation, leading to its long-term presence in the environment. This chemical bioaccumulates in ecosystems and in human tissue, particularly adipose tissue, raising concerns about chronic exposure. Emerging research links DDT exposure to adverse neurological outcomes, including increased risk for neurodegenerative disorders such as Parkinson’s Disease. Mechanistically, DDT and its metabolites may disrupt dopaminergic neurons, induce oxidative stress, and interfere with mitochondrial function, contributing to neurotoxicity. Understanding the environmental fate of DDT and its bioaccumulative properties is essential for …

Environmental Predictors Of Human Lyme Disease Incidence Across Appalachian Counties In Kentucky, Virginia, And West Virginia, 2000-2019, Karlie D. Rennison

Theses and Dissertations--Epidemiology and Biostatistics

This ecological study examined county-level environmental, landscape, and host-related predictors of Lyme disease incidence across Kentucky, Virginia, and West Virginia from 2000-2019. Lyme disease is an emerging public health concern in the Appalachian region, where geographic expansion and shifting ecological conditions may influence disease risk.

Lyme disease case rates (per 10,000 population) were analyzed in relation to climate variables, land cover metrics, host density measures, and rurality using publicly available data sources. Descriptive and regression analyses were conducted to evaluate associations between candidate predictors and disease incidence.

Substantial geographic variation in Lyme disease incidence was observed, with higher case rates …

Us Drug Policy Does Not Align With Experts' Rankings Of Drug Harms: A Multi-Criteria Decision Analysis, Michael Broman, Alan K. Davis, Stacey Armstrong, Adam Levin, Kaltum Ahmed, Gustavo A. Angarita, Brooke J. Arterberry, Cecilia Bergeria, Mitch Earleywine, Kathryn S. Gex, Tom Gregoire, Jamey J. Lister, David S. Mathai, Nicky J. Mehtani, Nathan Menke, Charles D. Nichols, Hillary Shaub, Alayna P. Tackett, Brandon Weiss, Nefize Yalin, Lawrence D. Phillips

School of Medicine Faculty Publications

Background United States drug policy is primarily based on the Controlled Substances Act of 1970 and largely contradicts scientific evidence about how to mitigate drugs' harms. Expert consensus on drug harms could inform policy that improves the health of people who use drugs while reducing negative societal impacts of drug use. Therefore, this study adapted and extended the relevant 2010 United Kingdom multi-criteria decision analysis, rating drug harms by criteria comprising health and social impacts to people who use drugs and their families, communities, and society.Methods Seventeen experts on drug use in the US, including three with lived experience of …

Large-Scale Experimental Study On The Impact Of Air Cleaning & Ventilation On Indoor Air Quality And Student Illness-Related Absenteeism, Daud Nosham

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

This large-scale randomized experimental field study investigated the effect of portable air purifiers (PAPs) on classroom’s air quality and student’s illness related absenteeism. PAPs were installed in 317 classrooms from various school districts located in Eastern Nebraska. The classrooms were randomly assigned into four conditions: three treatment conditions (T1, T2 & T3) and one control condition (device without any filter). T1 was equipped with HEPA filters, T2 added Activated Carbon (AC) layer to HEPA, and T3 further integrated Germicidal Ultraviolet (GUV) alongside HEPA and AC filters. The measured variables were carbon dioxide (CO2), fine particles (PN2.5) and coarse particles (PNcoarse), …

Alcohol Use Disorder, Kendall Walker, James Mcnary, Hamilton Farris

School of Medicine Faculty Publications

No abstract provided.

A Novel Mathematical Model Of Oropouche Virus Transmission Dynamics, Darsh Gandhi, Carli Peterson, Emma Slack, Elizabeth Rubio, Amira Claxton, Christopher M. Kribs

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

Rna Sequencing Reveals Inflammatory And Metabolic Changes In The Lung And Brain After Carbon Black And Naphthalene Whole Body Inhalation Exposure In A Rodent Model Of Military Burn Pit Exposures, Allison M. Haaning, Brian J. Sandri, Henry L. Wyneken, William T. Goldsmith, Joshua P. Nixon, Timothy R. Nurkiewicz, Chris H. Wendt, Paul Barach, Janeen H. Trembley, Tammy A. Butterick

College of Population Health Faculty Papers

Military personnel deployed to Iraq and Afghanistan were exposed to emissions from open-air burn pits, where plastics, metals, and medical waste were incinerated. These exposures have been linked to deployment-related respiratory diseases (DRRD) and may also impact neurological health via the lung-brain axis. To investigate molecular mechanisms, adult male rats were exposed to filtered air, naphthalene (a representative volatile organic compound), or a combination of naphthalene and carbon black (surrogate for particulate matter; CBN) via whole-body inhalation (six hours/day, three consecutive days). Lung, brain, and plasma samples were collected 24 h after the final exposure. Pro-inflammatory biomarkers were assessed using …

Identification And Preclinical Assessment Of Novel Therapeutic Modalities In Environmental Exposure-Induced Lung Disease, Aaron D. Schwab

Theses & Dissertations

Environmental lung diseases are preventable respiratory conditions either caused or made worse by inhaled environmental exposures. Contemporarily, environmental lung diseases are most associated with workplace exposures given specific occupational processes aerosolize inflammatory agents that can be inhaled at high concentrations. Although a considerable amount is known regarding immunoglobulin (Ig)E-mediated responses to environmental exposures, little is known about non-IgE mediated respiratory conditions resulting from lipopolysaccharide (LPS)-enriched organic dust exposure(s). Chronic respiratory diseases such as asthma, hypersensitivity pneumonitis, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis have all been identified as environmental lung diseases caused or exacerbated by such environmental dusts. Therapeutic …

Evaluation Of Human Mesenchymal Stromal Cells (Msc) As An Adjuvant Therapeutic For Chronic Lyme Disease, Matthew Teryek

Rowan-Virtua Research Day

Background: Lyme disease, caused by the spirochetal bacterium Borrelia burgdorferi, is the most prevalent vector-borne illness in the Northern Hemisphere. If undiagnosed or untreated, the disease progresses through multiple stages of increasing clinical severity. While antibiotics such as doxycycline and ceftriaxone are the current standard of care, patients with chronic or late-stage Lyme disease may require additional therapeutic interventions.

Rationale: Human mesenchymal stem cells (MSCs) are of growing clinical interest due to their immunomodulatory properties, low immunogenicity, and potential to promote tissue repair. These characteristics position MSCs as promising adjuvant therapies for chronic Lyme disease, with the potential to …

Igg4-Related Autoimmune Pancreatitis In Patients With Prior Occupational Exposure: A Case Report And Review Of Risks Concerning Blue-Collared Workers, Zachary A. Coren, Justin Le, Jason Tran, Nicholas Moscardelli, Krish Patel, Joshua Coren

Rowan-Virtua Research Day

Autoimmune pancreatitis (AIP), a manifestation of IgG4-related disease (IgG4-RD), is a rare, often misdiagnosed condition that can closely mimic pancreatic cancer, particularly in its clinical and radiographic presentation. We report the case of a 76-year-old retired plumber who presented with painless jaundice and was initially suspected to have pancreatic cancer based on imaging findings. Subsequent endoscopic evaluation, biopsy, and markedly elevated serum IgG4 levels led to a diagnosis of type 1 AIP. Treatment with corticosteroids resulted in rapid clinical improvement and reduction in IgG4 levels, confirming the diagnosis.

This case highlights the diagnostic challenges of AIP, especially among blue-collar workers …

An Unusual Cause Of Sepsis: Capnocytophaga Canimorsus, Capnocytophaga, Christopher Dellmyer, Kishan B. Patel

Rowan-Virtua Research Day

Septic shock can be caused by numerous different pathogens. A few of the more common causes are Streptococcus Pneumoniae, Staphylococcus Aureus, Escherichia Coli, Pseudomonas Aeruginosa, and Candida Albicans. Although these are the pathogens involved in the majority of septic shock cases, it is imperative to take the entire clinical picture into account when treating a patient with septic shock. Here we will discuss a seemingly unimpressive dog bite leading to Capnocytophaga canimorsus bacteremia, septic shock and end organ failure.

Chemical Exposures In Utero: Phthalates And Congenital Heart Defects, Demi Poulathas

Rowan-Virtua Research Day

Background: Congenital heart defects (CHDs) are the most common type of birth defect. Approximately 80% of CHDs have unknown causes, and phthalates may play a contributing role. Phthalates are ubiquitous environmental chemicals used as plasticizers in a wide range of products, including cosmetics and electronic devices. After entering the body, phthalates bind to the progesterone receptor, which is necessary for fetal development. While multiple studies have explored environmental factors in CHD development, few have examined the effects of phthalates on CHDs in humans. Methods: A literature review was conducted to investigate the relationship between parental occupational phthalate exposure and the …

Case Report: Cold Urticaria Diagnosed In The Emergency Department, Philip Carhart, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Cold urticaria can be primary (idiopathic) or can be due to underlying hematologic or infectious diseases. Here we present the case of a young female patient with no past medical history who was diagnosed with cold urticaria in the emergency department setting, using a cold stimulation test. Most cases are idiopathic. The reaction can be triggered in individual cases by exposure to cold objects or to generalized cold ambient temperatures, as was the case in the patient presented here. The physical response is most commonly pruritic wheals (urticaria). However, more severe symptoms may occur up to angioedema with hoarseness and …

The Impact Of Environmental Deficiencies On Maternal Health Outcomes, Zahra Wallizadeh, Emiyah Bullock, Antoinette Jones, Katarina Rusinak

Rowan-Virtua Research Day

This study examines the environmental factors contributing to adverse maternal health outcomes in New Jersey, with particular focus on their disproportionate impact on minority women. Analysis of data from PubMed, Policy Map, NIH, CDC, EPA, and the New Jersey Department of Health reveals that women living in low-income areas face significant environmental challenges, including food deserts, air pollution, unsafe living conditions, inadequate infrastructure, and limited transportation options. These environmental determinants exacerbate maternal stress and contribute to complications such as preterm birth and hypertension. Black women are nearly three times more vulnerable to these adverse outcomes compared to white women, highlighting …

Case Report: Alpha Gal Syndrome, Eric Haljasmaa, David Parkes, Wayne Tamaska

Rowan-Virtua Research Day

We report a case of a 40-year-old male who presented with sensation of throat closing and shortness of breath while at work at a meat processing facility. The differential diagnosis of shortness of breath is throat closing includes, but is not limited to, allergic reactions to antibiotics in meat, allergy to food additives, Symptom triggers are useful in identifying causes and a good supporting history and exposures can help with diagnosis. In this case, the patient had a known diagnosis of Alpha-gal syndrome (AGS) which is a tick-bite associated, possibly life-threatening immunoglobin E-mediated (IgE) hypersensitivity to galactose-alpha-1,3-galactose (alpha-gal). The patient …