Jefferey L Burgess

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• Beitel, S. C., Billheimer, D., Burgess, J. L., Cherrington, N. J., Gutenkunst, S. L., Hoppe-Jones, C., Jahnke, S. A., Jung, A. M., Littau, S. R., & White, M. (2023).

  Excretion of polybrominated diphenyl ethers and AhR activation in breastmilk among firefighters

  . Toxicological Sciences, 192(2), 223-232. doi:10.1093/toxsci/kfad017
• Feldstein, L. R., Britton, A., Beacham, L., Wiegand, R. E., Ruffin, J., Briggs‐Hagen, M., Fowlkes, A., Burgess, J. L., Cabán-Martinez, A. J., Chu, H. Y., Englund, J. A., Hegmann, K. T., Jeddy, Z., Lutrick, K., Martin, E. T., Meece, J. K., Midgley, C. M., Monto, A. S., Newes‐Adeyi, G., , Odame‐Bamfo, L., et al. (2023). 2082. Effectiveness of Bivalent mRNA Vaccines in Preventing SARS-CoV-2 Infection Among Children Aged 5-17 years: an Evaluation of Multicenter Prospective Cohorts, United States, September 2022 - January 2023. Open Forum Infectious Diseases, 10(Supplement_2). doi:10.1093/ofid/ofad500.152
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  Abstract Background The bivalent mRNA COVID-19 vaccine booster dose, composed of mRNA from ancestral and Omicron BA.4/BA.5 strains, was recommended for adolescents aged ≥12 years on September 1, 2022, and for children aged 5–11 years on October 12, 2022. However, data demonstrating the effectiveness of bivalent boosters among children and adolescents are limited. During Omicron variant sublineage predominance, September 4, 2022 – February 4, 2023, we conducted a multicenter prospective cohort study at 7 sites in the United States to assess vaccine effectiveness (VE) of bivalent COVID-19 vaccine boosters against laboratory-confirmed SARS-CoV-2 virus infection among children aged 5–17 years. Methods Participants collected weekly nasal swabs, irrespective of symptoms, and at onset of symptoms if present outside of their weekly swab cadence. Vaccination status was captured from periodic surveys (self-report), supplemented with queries from the state immunization information systems, and abstraction of electronic medical records system, when available. All respiratory swabs were tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction. Symptomatic infection was defined as ≥2 COVID-like illness symptoms within 7 days of specimen collection. Cox proportional hazards models were used to estimate hazard ratios of infections comparing participants with receipt of a bivalent booster to participants without (either unvaccinated or received monovalent only), adjusting for age, sex, race/ethnicity, underlying health conditions, prior infection status, geographic site, and local virus prevalence. Results Among 3,331 participants aged 5-17 years, adjusted VE against infection was 51% (95% CI: 29–66%). When stratified by age, adjusted VE was 48% (95% CI: 15-68%) for 5-11 year old participants and 55% (95% CI: 17-76%) for 12-17 year old participants. Against symptomatic infection, adjusted VE among 5-17 year old participants was 51% (95% CI: 14-72%). Conclusion These results demonstrate that the COVID-19 bivalent booster reduces risk of SARS-CoV-2 infection and symptomatic illness among children and adolescents. All eligible children and adolescents should remain up to date with recommended COVID-19 vaccinations. Disclosures Helen Y. Chu, MD, MPH, Abbvie: Advisor/Consultant|Ellume: Advisor/Consultant|Ellume: Grant/Research Support|Merck: Advisor/Consultant|Pfizer: Advisor/Consultant|Vir: Advisor/Consultant Janet A. Englund, MD, Ark Biopharma: Advisor/Consultant|AstraZeneca: Advisor/Consultant|AstraZeneca: Grant/Research Support|GlaxoSmithKline: Grant/Research Support|Meissa Vaccines: Advisor/Consultant|Merck: Grant/Research Support|Moderna: Advisor/Consultant|Moderna: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Sanofi Pasteur: Advisor/Consultant Emily T. Martin, PhD, MPH, Merck: Grant/Research Support Arnold Monto, MD, Roche: Advisor/Consultant|Roche: Honoraria
• Rivers, P., Jovel, K., Ramadan, F., Barnett, J., Ellingson, K., Burgess, J., & Lutrick, K. (2023).

  Disease and social factors associated with healthcare utilization for the treatment of SARS-CoV-2 infections in a longitudinal cohort of essential workers in Arizona

  . BMC Health Services Research, 23(1): 1118. doi:10.21203/rs.3.rs-3054726/v1
• Beamer, P., Beamer, P., Burgess, J. L., Burgess, J. L., Latura, J., Latura, J., Larson, D., Larson, D., Cabrera, N. L., Cabrera, N. L., Reynolds, K. A., Reynolds, K. A., Victory, K. R., Victory, K. R., Wilson, A. M., & Wilson, A. M. (2022). Measured and modeled comparisons of chemical and microbial contaminants in tap, bottled and vended water in a U.S.-Mexico Border community. Environmental Science & Technology Water, 2(12), 2657-2667.
• Beamer, P., Burgess, J. L., Sexton, J. D., Latura, J., Larson, D., Cabrera, N. L., Reynolds, K. A., Victory, K. R., & Wilson, A. M. (2022). Measured and modeled comparisons of chemical and microbial contaminants in tap, bottled and vended water in a U.S.-Mexico Border community. Environmental Science & Technology: Water.
• Beitel, S. C., Burgess, J. L., Coplen, C. P., Ellingson, K. D., Jergović, M., Lutrick, K., Nikolich-Žugich, J., Uhrlaub, J. L., & Watanabe, M. (2022).

  Cutting Edge: T Cell Responses to B.1.1.529 (Omicron) SARS-CoV-2 Variant Induced by COVID-19 Infection and/or mRNA Vaccination Are Largely Preserved

  . The Journal of Immunology, 208(11), 2461-2465. doi:10.4049/jimmunol.2200175
• Black, T. M., Burgess, J. L., Caban-Martinez, A. J., Datta, P., Gennaro, M. L., Graber, J. M., Hinton, K. M., Kubiel, B. S., Laumbach, R. J., Lu, S., Lubina, K., Rivera-Núñez, Z., Shah, N. N., & Ukey, R. (2022).

  Prevalence and predictors of SARS-CoV-2 seropositivity among volunteer firefighters (October 2020 - August 2021)

  . ISEE Conference Abstracts, 2022(1). doi:10.1289/isee.2022.p-0664
• Caban-Martinez, A. J., Gaglani, M., Olsho, L. E., Grant, L., Schaefer-Solle, N., Thompson, M. G., & Burgess, J. L. (2022).

  COVID-19 Vaccination Perspectives and Illnesses Among Law Enforcement Officers, Firefighters, and Other First Responders in the US, January to September 2021

  . JAMA Network Open, 5(7), e2222640. doi:10.1001/jamanetworkopen.2022.22640
• Caban-Martinez, A. J., Oduwole, S. O., Louzado-Feliciano, P., Schaefer-Solle, N., Coleman, A. D., Calafat, A., Popp, C., Hughes, J., Wallentine, D., Gulotta, J., Littau, S., Beitel, S. C., Grant, C., Graber, J. M., Calkins, M., Jung, A., Nematollahi, A., Fisher, J. M., & Burgess, J. L. (2022). Serum Per- and Polyfluoroalkyl Substances in Four Municipal US Fire Departments. American Journal of Industrial Medicine.
• Amarilla, P. A., Black, T., Black, K., Burgess, J. L., Caban Martinez, A. J., Calkins, M. M., Graber, J. M., Rivera Nunez, Z., Shah, N. N., & Steinberg, M. B. (2021).

  Per- and polyfluoroalkyl substances (PFAS) and non-fasting total cholesterol serum levels among New Jersey volunteer firefighters

  . ISEE Conference Abstracts, 2021(1). doi:10.1289/isee.2021.p-615
• Burgess, J., Caban-Martinez, A., Dunnigan, K., Edwards, L., Ellingson, K., Feliciano, P., Fowlkes, A., Gaglani, M., Gerald, J., Grant, L., Groom, H., Groover, K., Kuntz, J., Lundgren, J., Lutrick, K., Mak, J., Meece, J., Naleway, A., Odean, M., , Olsho, L., et al. (2021).

  Incidence of SARS-CoV-2 Infection among COVID-19 Vaccinated and Unvaccinated Healthcare Personnel, First Responders, and other Essential and Frontline Workers--- Eight U.S. Locations, January--September 2021

  . Influenza Other Respi Viruses, 16(3):585- 593.. doi:10.22541/au.163840666.67180024/v1
• Littau, S. R., Zhou, J., Wallentine, D. D., Moore, P. K., Littau, S. R., Jung, A. M., Gulotta, J., Burgess, J. L., & Beitel, S. C. (2021). Longitudinal evaluation of whole blood miRNA expression in firefighters.. Journal of Exposure Science and Environmental Epidemiology, 1-13. doi:10.1038/s41370-021-00306-8
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  BACKGROUND Dysregulated microRNA (miRNA) expression could provide a mechanism linking firefighter exposure to increased cancer risk. OBJECTIVE To determine if changes in longitudinal miRNA expression in firefighters are associated with occupational exposures. METHODS Whole blood MiRNA was evaluated in 52 new recruits prior to live-fire training and 20-37 months later. Linear mixed effects models adjusted for age, ethnicity, BMI, and batch effects were used to determine associations separately for all fires and structure fires only between employment duration, cumulative fire-hours and fire-runs, and time since most recent fire with (1) nine a priori and (2) the full array of 799 miRNAs. RESULTS For multivariable models including all fires, two a priori miRNAs were associated with employment duration and four with time since most recent fire. For multivariable models restricted to structure fires, three a priori miRNAs were associated with employment duration and one with fire-runs. Additional miRNAs from the full array were associated with employment duration for all fires and/or structure fires. In general, tumor suppressive miRNAs decreased and oncogenic miRNAs increased with exposure. SIGNIFICANCE Changes in miRNAs may serve as biomarkers of exposure effects and a mechanism for increased cancer risk in firefighters.
• Poplin, G., Griffin, S., Pollack, K., & Burgess, J. L. (2016). Efficacy of a proactive health and safety risk management system in the fire service. JOEM.
• Smith, D. L., Silvera, C. A., Santiago, K. M., Jahnke, S. A., Horn, G. P., Graber, J. M., Feliciano, P. L., Caban-martinez, A. J., & Burgess, J. L. (2021). COVID-19 Vaccine Acceptability among U.S. Firefighters and Emergency Medical Services Workers: A Cross-Sectional Study.. Journal of occupational and environmental medicine. doi:10.1097/jom.0000000000002152
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  Estimate the point prevalence of COVID-19 vaccine acceptability among U.S. firefighters and Emergency Medical Services (EMS) workers..A cross-sectional study design was used to administer an anonymous online survey to a national non-probabilistic sample of firefighter and EMS workers..Among the 3,169 respondents, 48.2% expressed high acceptability of the COVID-19 vaccine when it becomes available, while 24.2% were unsure and 27.6% reported low acceptability. Using the 'high COVID-19 vaccine acceptability' group as the reference category, the groups with greater odds of reporting low acceptability included those: 30-39 years of age (OR = 3.62 [95% confidence interval = 2.00-6.55]), Black race (3.60[1.12-11.53]), Hispanic/Latinx ethnicity (2.39[1.45-3.92]), with some college education (2.06[1.29-3.27]), married (1.65[1.03-2.65]), of current rank firefighter/ems (2.21[1.60-3.08])..Over half of U.S. firefighters and EMS workers were uncertain or reported low acceptability of the COVID-19 vaccine when it becomes available.
• Snyder, S. A., Littau, S. R., Hoppe-jones, C., Griffin, S. C., Zhou, J., Zhai, J., Wallentine, D. D., Snyder, S. A., Moore, P. K., Littau, S. R., Jung, A. M., Hoppe-jones, C., Gulotta, J., Griffin, S. C., Garavito, F., Flahr, L. M., Dearmon-moore, D., Burgess, J. L., & Beitel, S. C. (2021). Evaluation of fireground exposures using urinary PAH metabolites. Journal of Exposure Science and Environmental Epidemiology, 1-10. doi:10.1038/s41370-021-00311-x
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  Background Firefighters have increased cancer incidence and mortality rates compared to the general population, and are exposed to multiple products of combustion including known and suspected carcinogens. Objective The study objective was to quantify fire response exposures by role and self-reported exposure risks. Methods Urinary hydroxylated metabolites of polycyclic aromatic hydrocarbons (PAH-OHs) were measured at baseline and 2-4 h after structural fires and post-fire surveys were collected. Results Baseline urine samples were collected from 242 firefighters. Of these, 141 responded to at least one of 15 structural fires and provided a post-fire urine. Compared with baseline measurements, the mean fold change of post-fire urinary PAH-OHs increased similarly across roles, including captains (2.05 (95% CI 1.59-2.65)), engineers (2.10 (95% CI 1.47-3.05)), firefighters (2.83 (95% CI 2.14-3.71)), and paramedics (1.84 (95% CI 1.33-2.60)). Interior responses, smoke odor on skin, and lack of recent laundering or changing of hoods were significantly associated with increased post-fire urinary PAH-OHs. Significance Ambient smoke from the fire represents an exposure hazard for all individuals on the fireground; engineers and paramedics in particular may not be aware of the extent of their exposure. Post-fire surveys identified specific risks associated with increased exposure.
• Staack, S. D., Lutz, E. A., Lee, V. S., Griffin, S. C., & Burgess, J. L. (2021). Evaluation of CBRN Respirator Protection in Simulated Fire Overhaul Settings.. Annals of work exposures and health, 65(7), 843-853. doi:10.1093/annweh/wxab004
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  Overhaul is the phase of firefighting after flames have been extinguished but when products of combustion are still being released. While positive pressure self-contained breathing apparatus (SCBA) provide the highest level of respiratory protection during overhaul, use of air-purifying respirators (APRs) with suitable filters could potentially provide a lower weight, longer duration option for first responders. The objective of this study was to assess whether an APR with a chemical, biological, radiological, and nuclear (CBRN) canister could be recommended as substitution for SCBA during overhaul. A total of 15 simulated standard overhaul environments were created by burning household materials. Sampling was conducted using mannequin heads fitted with full facepiece respirators with either a CBRN canister or SCBA. In-mask and personal samples were collected for aldehydes, polynuclear aromatic hydrocarbons, inorganic acids, aromatic hydrocarbons, nitrogen dioxide, and particulate matter. An additional six simulated high-exposure overhaul environments were created in a flashover chamber by continuously adding household materials to a smoldering fire. The sampling train was the same for both the standard and high-exposure environments; however, the facepiece was sealed to the mannequin head in the high-exposure environments. In the standard overhaul environment, the CBRN canister effectively reduced the level of exposure for most contaminants, while in the high-exposure overhaul exposure setting in-mask acetaldehyde and formaldehyde were detected. In both exposure settings, the SCBA prevented almost all exposure, and therefore remains the recommended respiratory protection during overhaul.
• Vega-millan, C. B., Rourke, M. K., Meza-montenegro, M. M., Meza-figueroa, D., Meza-escalante, E. R., Lantz, R. C., Garcia-rico, L., Furlong, M., Devora-figueroa, A. G., Burgess, J. L., Beamer, P. I., & Balderas-cortes, J. J. (2021). Inflammation biomarkers associated with arsenic exposure by drinking water and respiratory outcomes in indigenous children from three Yaqui villages in southern Sonora, México.. Environmental science and pollution research international. doi:10.1007/s11356-021-13070-x
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  Environmental arsenic exposure in adults and children has been associated with a reduction in the expression of club cell secretory protein (CC16) and an increase in the expression of matrix metalloproteinase-9 (MMP-9), both biomarkers of lung inflammation and negative respiratory outcomes. The objectives of this study were to determine if the levels of serum CC16 and MMP-9 and subsequent respiratory infections in children are associated with the ingestion of arsenic by drinking water. This cross-sectional study included 216 children from three Yaqui villages, Potam, Vicam, and Cocorit, with levels of arsenic in their ground water of 70.01 ± 21.85, 23.3 ± 9.99, and 11.8 ± 4.42 μg/L respectively. Total arsenic in water and urine samples was determined by inductively coupled plasma/optical emission spectrometry. Serum was analyzed for CC16 and MMP-9 using ELISA. The children had an average urinary arsenic of 79.39 μg/L and 46.8 % had levels above of the national concern value of 50 μg/L. Increased arsenic concentrations in drinking water and average daily arsenic intake by water were associated with decreased serum CC16 levels (β = - 0.12, 95% CI - 0.20, - 0.04 and β = - 0.10, 95% CI - 0.18, - 0.03), and increased serum MMP-9 levels (β = 0.35, 95% CI 0.22, 0.48 and β = 0.29, 95% CI 0.18, 0.40) at significant levels (P < 0.05). However, no association was found between levels of these serum biomarkers and urinary arsenic concentrations. In these children, reduced serum CC16 levels were significantly associated with increased risk of respiratory infections (OR = 0.34, 95% CI 0.13, 0.90). In conclusion, altered levels of serum CC16 and MMP-9 in the children may be due to the toxic effects of arsenic exposure through drinking water.
• Yoo, Y. M., Yoo, Y. M., Thornburg, N. J., Thornburg, N. J., Thompson, M. G., Thompson, M. G., Sun, X., Sun, X., Rivers, P., Rivers, P., Parker, J., Parker, J., Nikolich-zugich, J., Nikolich-zugich, J., Meece, J. K., Meece, J. K., Lutrick, K., Lutrick, K., Lamberte, J. M., , Lamberte, J. M., et al. (2021). COVID-19 Infection, Reinfection, and Vaccine Effectiveness in a Prospective Cohort of Arizona Frontline/Essential Workers: The AZ HEROES Research Protocol.. JMIR research protocols. doi:10.2196/28925
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  The Arizona Healthcare, Emergency Response, and Other Essential workers Study (AZ HEROES) aims to examine the epidemiology of SARS-CoV-2 infection and COVID-19 illness among adults with high occupational exposure risk..Study objectives include estimating incidence of SARS-CoV-2 infection in essential workers by symptom presentation and demographic factors, determining independent effects of occupational and community exposures on incidence of SARS-CoV-2 infection, establishing molecular and immunologic characteristics of SARS-CoV-2 infection in essential workers, describing the duration and patterns of rRT-PCR-positivity, and examining post-vaccine immunologic response..Eligible participants include Arizona residents aged 18-85 years who work at least 20 hours per week in an occupation involving regular direct contact (within three feet) with others. Recruitment goals are stratified by demographic characteristics (50% aged 40 or older, 50% women, and 50% Hispanic or American Indian), by occupation (40% healthcare personnel, 30% first responders, and 30% other essential workers), and by prior SARS-CoV-2 infection (with up to 50% seropositive at baseline). Information on sociodemographics, health and medical history, vaccination status, exposures to individuals with suspected or confirmed SARS-CoV-2 infection, use of personal protective equipment, and perceived risks are collected at enrollment and updated through quarterly surveys. Every week, participants complete active surveillance for COVID-19-like illness (CLI) and self-collect nasal swabs. Additional self-collected nasal swab and saliva specimens are collected in the event of CLI onset. Respiratory specimens are sent to Marshfield Laboratories and tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (rRT-PCR) assay. CLI symptoms and impact on work and productivity are followed through illness resolution. Serum specimens are collected every 3 months and additional sera are collected following incident rRT-PCR positivity and after each COVID-19 vaccine dose. Incidence of SARS-CoV-2 infections will be calculated by person-weeks at risk and compared by occupation and demographic characteristics and by seropositivity status and infection and vaccination history..The AZ HEROES study was funded by the Centers for Disease Control and Prevention. Enrollment began July 27, 2020 and as of May 1, 2021 a total of 3,165 participants have been enrolled in the study..AZ HEROES is unique in aiming to recruit a diverse sample of essential workers and prospectively following strata of SARS-CoV-2 seronegative and seropositive adults. Survey results combined with active surveillance data on exposure, CLI, weekly molecular diagnostic testing, and periodic serology will be used to estimate the incidence of symptomatic and asymptomatic SARS-CoV-2 infection, assess the intensity and durability of immune responses to natural infection and COVID-19 vaccination, and contribute to the evaluation of COVID-19 vaccine effectiveness..DERR1-10.2196/28925.
• Yu, C. H., Turyk, M. E., Steinberg, M. B., Shah, N. N., Lu, S., Graber, J. M., Fan, Z., Caban-martinez, A. J., Burgess, J. L., Brancard, T., Black, T. M., & Black, K. (2021). Prevalence and Predictors of Per- and Polyfluoroalkyl Substances (PFAS) Serum Levels among Members of a Suburban US Volunteer Fire Department.. International journal of environmental research and public health, 18(7). doi:10.3390/ijerph18073730
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  Per-and polyfluoroalkyl substances (PFAS), are ubiquitous pollutants associated with adverse health outcomes. High PFAS levels have been demonstrated among career firefighters; less is known about PFAS levels among volunteer firefighters who comprise two-thirds of US firefighters..Volunteer fire department members completed a survey and provided blood samples. We calculated geometric means and 95% CIs for PFAS reported by the National Health and Nutrition Examination Survey (NHANES). We compared PFAS distribution and levels among non-Hispanic white adult male study participants to those in the 2015-2016 and 2017-2018 NHANES cycles. We assessed associations between PFAS serum levels and years of firefighting controlling demographics and occupation using linear regression..Participant's average age was 46.6 years (sd. 17.1). Perfluorododecanoic acid (PFDoA) was detected in almost half study but
• Zunie, T., Yoon, S. K., Yoo, Y. M., Wesley, M. G., Tyner, H. L., Thompson, M. G., Thiese, M. S., Sun, X., Stefanski, E. L., Smith, M. E., Schaefer-solle, N., Rivers, P., Phillips, A. L., Olsho, L. E., Odean, M. J., Naleway, A. L., Morrill, T. C., Meece, J. K., Mak, J., , Lutrick, K., et al. (2021). Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers - Eight U.S. Locations, December 2020-March 2021.. MMWR. Morbidity and mortality weekly report, 70(13), 495-500. doi:10.15585/mmwr.mm7013e3
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  Messenger RNA (mRNA) BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines have been shown to be effective in preventing symptomatic COVID-19 in randomized placebo-controlled Phase III trials (1,2); however, the benefits of these vaccines for preventing asymptomatic and symptomatic SARS-CoV-2 (the virus that causes COVID-19) infection, particularly when administered in real-world conditions, is less well understood. Using prospective cohorts of health care personnel, first responders, and other essential and frontline workers* in eight U.S. locations during December 14, 2020-March 13, 2021, CDC routinely tested for SARS-CoV-2 infections every week regardless of symptom status and at the onset of symptoms consistent with COVID-19-associated illness. Among 3,950 participants with no previous laboratory documentation of SARS-CoV-2 infection, 2,479 (62.8%) received both recommended mRNA doses and 477 (12.1%) received only one dose of mRNA vaccine.† Among unvaccinated participants, 1.38 SARS-CoV-2 infections were confirmed by reverse transcription-polymerase chain reaction (RT-PCR) per 1,000 person-days.§ In contrast, among fully immunized (≥14 days after second dose) persons, 0.04 infections per 1,000 person-days were reported, and among partially immunized (≥14 days after first dose and before second dose) persons, 0.19 infections per 1,000 person-days were reported. Estimated mRNA vaccine effectiveness for prevention of infection, adjusted for study site, was 90% for full immunization and 80% for partial immunization. These findings indicate that authorized mRNA COVID-19 vaccines are effective for preventing SARS-CoV-2 infection, regardless of symptom status, among working-age adults in real-world conditions. COVID-19 vaccination is recommended for all eligible persons.
• Black, T., Black, K., Brancard, T., Burgess, J., Graber, J., Lu, S., Shah, N., & Steinberg, M. (2020).

  Per- and polyfluoroalkyl substances (PFAS) serum levels among a group of New Jersey volunteer firefighters and comparison with the US National Health and Nutrition Examination Survey (NHANES) (2015-16)

  . ISEE Conference Abstracts, 2020(1). doi:10.1289/isee.2020.virtual.p-0885
• Harris, R. B., Hadeed, S. J., O'rourke, M. K., Harris, R. B., Hadeed, S. J., Canales, R. A., & Burgess, J. L. (2020). Imputation methods for addressing missing data in short-term monitoring of air pollutants.. The Science of the total environment, 730, 139140. doi:10.1016/j.scitotenv.2020.139140
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  Monitoring of environmental contaminants is a critical part of exposure sciences research and public health practice. Missing data are often encountered when performing short-term monitoring (
• Hoppe-jones, C., Griffin, S. C., Littau, S. R., Garavito, F., Snyder, S. A., Zhou, J. J., Zhai, J., Weller, S. R., Wallentine, D. D., Valliere, E. A., Snyder, S. A., Moore, P. K., Littau, S. R., Jung, A. M., Hoppe-jones, C., Gulotta, J. J., Griffin, S. C., Garavito, F., Flahr, L. M., , Dearmon-moore, D., et al. (2020). Evaluation of Interventions to Reduce Firefighter Exposures.. Journal of occupational and environmental medicine, 62(4), 279-288. doi:10.1097/jom.0000000000001815
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  Evaluate the effectiveness of firefighter exposure reduction interventions..Fireground interventions included use of self-contained breathing apparatus by engineers, entry team wash down, contaminated equipment isolation, and personnel showering and washing of gear upon return to station. Urinary polycyclic aromatic hydrocarbon metabolites (PAH-OHs) were measured after structural fire responses before and after intervention implementation. Separately, infrared sauna use following live-fire training was compared to standard postfire care in a randomized trial..The fireground interventions significantly reduced mean total urinary postfire PAH-OHs in engineers (-40.4%, 95%CI -63.9%, -2.3%) and firefighters (-36.2%, 95%CI -56.7%, -6.0%) but not captains (-11.3% 95%CI -39.4%, 29.9%). Sauna treatment non-significantly reduced total mean PAH-OHs by -43.5% (95%CI -68.8%, 2.2%)..The selected fireground interventions reduced urinary PAH-OHs in engineers and firefighters. Further evaluation of infrared sauna treatment is needed.
• Hoppe-jones, C., Littau, S. R., Snyder, S. A., Wallentine, D. D., Snyder, S. A., Moore, P. K., Littau, S. R., Hoppe-jones, C., Gulotta, J., Flahr, L. M., Burgess, J. L., & Beitel, S. C. (2020). Assessment of the toxicity of firefighter exposures using the PAH CALUX bioassay.. Environment international, 135, 105207. doi:10.1016/j.envint.2019.105207
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  Firefighters can be exposed to a complex set of contaminants while at a fire scene. Identifying new ways to monitor and assess exposure, particularly relating to toxicity is essential to determine the effectiveness of intervention techniques to reduce exposure. This study investigated the use of the polycyclic aromatic hydrocarbon (PAH) CALUX® bioassay for the assessment of exposure and associated toxicity firefighters might encounter. This was done through analysis of extracts of dermal wipes and urine samples collected from firefighters before and after a controlled fire. An increased bioassay response was observed from post-fire neck and calf samples, indicating a greater concentration of PAH-like compounds on the skin. The use of a baby wipe to clean the face and neck during rehab resulted in the attenuation of the observed bioassay response from the neck post-fire. Though a correlation was observed between the bioassay response and hydroxylated PAH concentrations found in the urine, the increased bioassay response from the post-fire urine samples was likely due to unknown compounds other than the hydroxylated PAHs tested. Our results suggest that this bioassay provides a useful measure of firefighter exposure, particularly relating to the potential toxicity of contaminants.
• Littau, S. R., Billheimer, D., Sinari, S., Littau, S. R., Khalil, N., Hu, C., Ducatman, A. M., Burgess, J. L., & Billheimer, D. (2020). Per- and Polyfluoroalkyl Substance and Cardio Metabolic Markers in Firefighters.. Journal of occupational and environmental medicine, 62(12), 1076-1081. doi:10.1097/jom.0000000000002062
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  To evaluate if serum polyfluoroalkyl substances (PFAS) were associated with cardiometabolic markers..Serum PFAS were evaluated in 38 Arizona firefighters and 49 participants from the 2009 to 2010 National Health and Nutrition Examination Survey (NHANES). Cardiometabolic markers including carotid intima-medial thickness (CIMT) were measured in the firefighters..Firefighters had elevated perfluorohexane sulfonic acid (PFHxS) and lower perfluorononanoic acid (PFNA) and perfluoroundecanoic acid (PFUA) compared to NHANES participants; for nine of the other 12 PFAS the values were not significantly different. There were significant negative associations among firefighters between perfluorodecanoic acid (PFDeA) and total cholesterol and PFUA and interleukin-6. PFAS concentrations were not associated with CIMT..PFHxS levels were elevated in firefighters compared to NHANES subjects. Serum PFAS concentrations were not associated with increased cardiometabolic risk measures in this population of firefighters.
• O'rourke, M. K., Mondaca-fernandez, I., Meza-montenegro, M. M., Meza-figueroa, D., Martinez-cinco, M. A., Lantz, C. R., Garcia-rico, L., Furlong, M., Burgess, J. L., Beamer, P. I., & Balderas-cortes, J. J. (2020). Serum matrix metalloproteinase-9 in children exposed to arsenic from playground dust at elementary schools in Hermosillo, Sonora, Mexico.. Environmental geochemistry and health, 42(2), 499-511. doi:10.1007/s10653-019-00384-6
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  Arsenic exposure in adults has been associated with increased serum matrix metalloproteinase-9 (MMP-9), a biomarker which is associated with chronic respiratory disease, lung inflammation, cardiovascular disease and cancer. The objective of this study was to evaluate the association between serum MMP-9 levels in children, urinary arsenic, arsenic chronic daily intake (CDI) and arsenic exposure from playground dust. This cross-sectional study examined 127 children from five elementary schools, in Hermosillo, Sonora, Mexico. Arsenic was analyzed in the dust using a portable X-ray fluorescence (XRF) analyzer. Total urinary arsenic was determined by inductively coupled plasma/optical emission spectrometry. Serum was analyzed for MMP-9 using ELISA. Arsenic levels in playground dust averaged 16.9 ± 4.6 mg/kg. Urinary arsenic averaged 34.9 ± 17.1 µg/L. Arsenic concentration in playground dust was positively associated with serum MMP-9 levels in crude analyses and after adjustment (P < 0.01), MMP-9 and CDI were positively associated only after adjustment (P < 0.01), and no association was found between MMP-9 and urinary arsenic. In conclusion, our study showed an association in children between serum MMP-9 levels and playground dust arsenic concentrations. Therefore, exposure to arsenic in dust where children spend significant time may manifest toxic effects.
• Bui, D. P., Hu, C., Jung, A. M., Pollack Porter, K. M., Griffin, S. C., French, D. D., Crothers, S., & Burgess, J. L. (2019). Driving behaviors associated with emergency service vehicle crashes in the U.S. fire service. Traffic Injury Prevention, 19(8), 849-855. doi:10.1080/15389588.2018.1508837
• Griffin, S. C., Littau, S. R., Peate, W. F., Chen, Y., Zhou, J., Zhai, J., Peate, W. F., Littau, S. R., Lance, P., Jung, A. M., Jeong, K. S., Jenkins, T. G., Jacobs, E. T., Griffin, S. C., Ellis, N. A., Dearmon-moore, D., Chen, Y., & Burgess, J. L. (2019). DNA methylation among firefighters.. PloS one, 14(3), e0214282. doi:10.1371/journal.pone.0214282
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  Firefighters are exposed to carcinogens and have elevated cancer rates. We hypothesized that occupational exposures in firefighters would lead to DNA methylation changes associated with activation of cancer pathways and increased cancer risk. To address this hypothesis, we collected peripheral blood samples from 45 incumbent and 41 new recruit non-smoking male firefighters and analyzed the samples for DNA methylation using an Illumina Methylation EPIC 850k chip. Adjusting for age and ethnicity, we performed: 1) genome-wide differential methylation analysis; 2) genome-wide prediction for firefighter status (incumbent or new recruit) and years of service; and 3) Ingenuity Pathway Analysis (IPA). Four CpGs, including three in the YIPF6, MPST, and PCED1B genes, demonstrated above 1.5-fold statistically significant differential methylation after Bonferroni correction. Genome-wide methylation predicted with high accuracy incumbent and new recruit status as well as years of service among incumbent firefighters. Using IPA, the top pathways with more than 5 gene members annotated from differentially methylated probes included Sirtuin signaling pathway, p53 signaling, and 5' AMP-activated protein kinase (AMPK) signaling. These DNA methylation findings suggest potential cellular mechanisms associated with increased cancer risk in firefighters.
• Griffin, S. C., Porter, K. P., Jung, A. M., Hu, C., Griffin, S. C., French, D. D., Crothers, S., Burgess, J. L., & Bui, D. P. (2019). The use of proactive risk management to reduce emergency service vehicle crashes among firefighters.. Journal of safety research, 71, 103-109. doi:10.1016/j.jsr.2019.09.020
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  Emergency service vehicle crashes (ESVCs), including rollovers and collisions with other vehicles and fixed objects, are a leading cause of death among U.S. firefighters. Risk management (RM) is a proactive intervention to identifying and mitigating occupational risks and hazards. The goal of this study was to assess the effect of RM in reducing ESVCs..Three fire departments (A, B and C), representing urban and suburban geographies, and serving medium to large populations, participated in facilitated RM programs to reduce their ESVCs. Interventions were chosen by each department to address their department-specific circumstances and highest risks. Monthly crash rates per 10,000 calls were calculated for each department an average of 28 months before and 23 months after the start of the RM programs. Interrupted time series analysis was used to assess the effect of the RM programs on monthly crash rates. Poisson regression was used to estimate the number of crashes avoided. Economic data from Department A were analyzed to estimate cost savings..Department A had a 15.4% (P = 0.30) reduction in the overall monthly crash rate immediately post-RM and a 1% (P = 0.18) decline per month thereafter. The estimated two-year average cost savings due to 167 crashes avoided was $253,100 (95%CI= $192,355 - $313,885). Department B had a 9.7% (P = 0.70) increase in the overall monthly crash rate immediately post-RM and showed no significant changes in their monthly crash rate. Department C had a 28.4% (P = 0.001) reduction in overall monthly crash rate immediately post-RM and a 1.2% (P = 0.09) increase per month thereafter, with an estimated 122 crashes avoided..RM programs have the potential to reduce ESVCs in the fire service and their associated costs; results may vary based on the interventions chosen and how they are implemented. Practical applications: Risk management may be an effective and broadly implemented intervention to reduce ESVCs in the US fire service.
• Solle, N. S., Santiago, K. M., Lee, D. J., Kobetz, E. N., Griffin, K., Fent, K. W., Feliciano, P. L., Deo, S. K., Daunert, S., Calkins, M., Caban-martinez, A. J., & Burgess, J. L. (2019). Use of Aqueous Film-Forming Foams and Knowledge of Perfluorinated Compounds Among Florida Firefighters.. Journal of occupational and environmental medicine, 61(5), e227-e231. doi:10.1097/jom.0000000000001566
• Arora, M., Zepeda, T. K., Granillo, B., Burgess, J. L., & Arora, M. (2018). Experiential Adult Learning: A Pathway to Enhancing Medical Countermeasures Capabilities.. American journal of public health, 108(S5), S378-S380. doi:10.2105/ajph.2018.304703
• Bui, D. P., Jung, A. M., Kramer, S. S., Griffin, S., & Burgess, J. L. (2018). Interventions and Controls to Prevent Emergency Service Vehicle Incidents: A Mixed Methods Review. Accident and Injury Prevention.
• Burgess, J. L., Zhou, J., Griffin, S., & Jacobs, E. T. (2018). MicroRNA changes in firefighters. JOEM.
• Griffin, S. C., Bui, D. P., Gowrisankaran, G., Lutz, E. A., He, C., Hu, C., & Burgess, J. L. (2018). Risk Management Interventions to Reduce Injuries and Maximize Economic Benefits in U.S. Mining. Journal of occupational and environmental medicine, 60(3), 226-233.
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  Risk management (RM) is a cyclical process of identifying and ranking risks, implementing controls, and evaluating their effectiveness. This study aims to identify effective RM interventions in the U.S. mining industry.
• Jacobs, E. T., Burgess, J. L., & Abbott, M. B. (2018). The Donora Smog Revisited: 70 Years After the Event That Inspired the Clean Air Act. American journal of public health, 108(S2), S85-S88.
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  At a storefront museum approximately 25 miles southeast of Pittsburgh, Pennsylvania, a sign reads, "Clean Air Started Here." This is not hyperbole. At the end of October 1948, the communities of Donora and Webster in Pennsylvania were visited by a smog that changed the face of environmental protection in the United States. Conservative estimates showed that 20 individuals died, while an additional 5900-43% of the population of Donora-were affected by the smog. This event led to the first large-scale epidemiological investigation of an environmental health disaster in the United States. Questions remain about the long-term effects of the smog, because higher rates of cardiovascular disease and cancer than were expected were observed in the region in the decade following the smog. Recent work has suggested that environmental contaminants from a bygone era in Donora might have an impact even today. In addition, reports regarding air pollution have indicated that levels of pollutants similar to those estimated to have occurred in Donora are currently present in some rapidly industrializing regions of China and India. Seventy years after the smog, this event still resonates.
• Maldonado Escalante, J. F., Meza Figueroa, D., Dévora Figueroa, A. G., García Rico, L., Burgess, J. L., Lantz, R. C., Yañez Estrada, L., Martínez Cinco, M. A., Balderas Cortés, J. d., Mondaca Fernández, I., & Meza Montenegro, M. M. (2018). An integrated health risk assessment of indigenous children exposed to arsenic in Sonora, Mexico. Human and Ecological Risk Assessment: An International Journal. doi:10.1080/10807039.2018.1449098
• Meza Montenegro, M. M., Mondaca Fernández, I., Balderas Cortés, J. d., Martínez Cinco, M. A., Yañez Estrada, L., Lantz, R. C., Burgess, J. L., García Rico, L., Dévora Figueroa, A. G., Meza Figueroa, D., & Maldonado Escalante, J. F. (2018). An integrated health risk assessment of indigenous children exposed to arsenic in Sonora, Mexico. Human and Ecological Risk Assessment: An International Journal, 25(3), 706-721. doi:10.1080/10807039.2018.1449098
• Poplin, G. S., Griffin, S., Pollack Porter, K., Mallett, J., Hu, C., Day-Nash, V., & Burgess, J. L. (2018). Efficacy of a proactive health and safety risk management system in the fire service. Injury epidemiology, 5(1), 18.
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  This study evaluated the efficacy of a fire department proactive risk management program aimed at reducing firefighter injuries and their associated costs.
• Wada, K., Schunder-tatzber, S., Rotthier, S., Kubo, T., Descatha, A., Committee, E. S., Cassan, P., Burgess, J. L., & Baer, M. (2018). 921 Position statement of the icoh working group on ‘emergency preparedness and response in occupational health (eproh)’. Occupational and Environmental Medicine, 75. doi:10.1136/oemed-2018-icohabstracts.336
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  Introduction The Emergency Preparedness and Response in Occupational Health (EPROH) scientific committee was developed to raise awareness of emergency risks for workers, to train managers, employees, and medical staff to prepare for and prevent accidents, acute medical events and disasters, and to mitigate their impact. The committee proposes a position statement on the fundamental need for prevention, response, first-aid treatment, and care in the field of occupational health care. Methods This position statement was developed following Evidence Based Medicine principles, including literature review, practice networking, and surveys including workers’ expectations. Result The scope of the EPROH group will be focused on Emergency Plans, Procedures, Preparedness, and Training. To ameliorate the dramatic situation of workplace fatalities and accidents/events, EPROH experts have developed recommendations for what every worker should expect in case of a medical emergency, work-related or not, minor or major, while working for his/her company. Minimum response plans for every workplace include information about initial management and contact information. First aid must be encouraged, and occupational health and safety professionals will have to develop procedures that detail responses to emergencies, from minor events to major disasters. As needed, emergency providers should be followed up regularly by an occupational specialist for extended intervals after an event. Discussion Although global harmonisation, local adaptation, and additional research are needed, this position statement emphasises the importance of having a global statement on the multiple aspects of emergency preparedness and response in occupational settings for every worker everywhere in the world.
• Griffin, S. C., Porter, K. P., Jung, A. M., Griffin, S. C., French, D. D., Crothers, S., Burgess, J. L., & Bui, D. P. (2017). Correction to: Risk management of emergency service vehicle crashes in the United States fire service: process, outputs, and recommendations.. BMC public health, 17(1), 923. doi:10.1186/s12889-017-4946-8
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  After publication of the article [1], it has been brought to our attention that the second author's name was published incorrectly. Previously included as "Keshia P. Porter", the full and correct name should be "Keshia Pollack Porter". This has now been corrected in the original version of the article.
• Griffin, S. C., Porter, K. P., Jung, A. M., Griffin, S. C., French, D. D., Crothers, S., Burgess, J. L., & Bui, D. P. (2017). Risk management of emergency service vehicle crashes in the United States fire service: process, outputs, and recommendations.. BMC public health, 17(1), 885. doi:10.1186/s12889-017-4894-3
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  Emergency service vehicle crashes (ESVCs) are a leading cause of death in the United States fire service. Risk management (RM) is a proactive process for identifying occupational risks and reducing hazards and unwanted events through an iterative process of scoping hazards, risk assessment, and implementing controls. We describe the process, outputs, and lessons learned from the application of a proactive RM process to reduce ESVCs in US fire departments..Three fire departments representative of urban, suburban, and rural geographies, participated in a facilitated RM process delivered through focus groups and stakeholder discussion. Crash reports from department databases were reviewed to characterize the context, circumstances, hazards and risks of ESVCs. Identified risks were ranked using a risk matrix that considered risk likelihood and severity. Department-specific control measures were selected based on group consensus. Interviews, and focus groups were used to assess acceptability and utility of the RM process and perceived facilitators and barriers of implementation..Three to six RM meetings were conducted at each fire department. There were 7.4 crashes per 100 personnel in the urban department and 10.5 per 100 personnel in the suburban department; the rural department experienced zero crashes. All departments identified emergency response, backing, on scene struck by, driver distraction, vehicle/road visibility, and driver training as high or medium concerns. Additional high priority risks varied by department; the urban department prioritized turning and rear ending crashes; the suburban firefighters prioritized inclement weather/road environment and low visibility related crashes; and the rural volunteer fire department prioritized exiting station, vehicle failure, and inclement weather/road environment related incidents. Selected controls included new policies and standard operating procedures to reduce emergency response, cameras to enhance driver visibility while backing, and increased training frequency and enhanced training. The RM process was generally acceptable to department participants and considered useful. All departments reported that the focused and systematic analysis of crashes was particularly helpful. Implementation of controls was a commonly cited challenge..Proactive RM of ESVCs in three US fire departments was positively received and supported the establishment of interventions tailored to each department's needs and priorities.
• Kurzius-spencer, M., Harris, R. B., Thomson, C. A., Silva, V. D., O'rourke, M. K., Kurzius-spencer, M., Hsu, C. H., Hartz, V., Harris, R. B., & Burgess, J. L. (2017). Nutrients in one-carbon metabolism and urinary arsenic methylation in the National Health and Nutrition Examination Survey (NHANES) 2003-2004.. The Science of the total environment, 607-608, 381-390. doi:10.1016/j.scitotenv.2017.07.019
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  Exposure to inorganic arsenic (inAs), a potent toxicant, occurs primarily through ingestion of food and water. The efficiency with which it is methylated to mono and dimethyl arsenicals (MMA and DMA) affects toxicity. Folate, vitamins B12 and B6 are required for 1C metabolism, and studies have found that higher levels of these nutrients increase methylation capacity and are associated with protection against adverse health effects from inAs, especially in undernourished populations. Our aim was to determine whether 1C-related nutrients are associated with greater inAs methylation capacity in a general population sample with overall adequate nutrition and low levels of As exposure. Univariate and multivariable regression models were used to evaluate the relationship of dietary and blood nutrients to urinary As methylation in the National Health and Nutrition Examination Survey (NHANES) 2003-2004. Outcome variables were the percent of the sum of inAs and methylated As species (inAs+MMA+DMA) excreted as inAs, MMA, and DMA, and the ratio of MMA:DMA. In univariate models, dietary folate, vitamin B6 and protein intake were associated with lower urinary inAs% and greater DMA% in adults (≥18years), with similar trends in children (6-18). In adjusted models, vitamin B6 intake (p=0.011) and RBC folate (p=0.036) were associated with lower inAs%, while dietary vitamin B12 was associated with higher inAs% (p=0.002) and lower DMA% (p=0.030). Total plasma homocysteine was associated with higher MMA% (p=0.004) and lower DMA% (p=0.003), but not with inAs%; other blood nutrients showed no association with urinary As. Although effect size is small, these findings suggest that 1C nutrients can influence inAs methylation and potentially play an indirect role in reducing toxicity in a general population sample.
• Reed, R. J., Lutz, E. A., Lee, V. S., & Burgess, J. L. (2017). Comparison of personal diesel and biodiesel exhaust exposures in an underground mine.. Journal of occupational and environmental hygiene, 14(7), D102-D109. doi:10.1080/15459624.2017.1285488
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  This study aimed to compare personal exposures to diesel fuel and a biodiesel blend exhaust in an underground mine. Personal exposure monitoring was performed in a non-operational, hard rock underground mine during use of a load-haul-dump vehicle. Eight-hour time-weighted average (TWA8) exposure concentrations of ultra-low sulfur diesel and 75% biodiesel/25% diesel blend (B75) fuels were compared. Compared to diesel, use of B75 was associated with relative percent reductions of 22 and 28% in median respirable (r) diesel particulate matter (DPM) and nitrogen dioxide and 25 and 23% increases in median total DPM and nitric oxide TWA8 exposure concentrations, respectively. Diesel was associated with a slightly greater total geometric mean mass concentration and lower mean surface area concentration. Although further testing is needed, B75 has the potential to reduce rDPM exposures.
• Wada, K., Schunder-tatzber, S., Rotthier, S., Kubo, T., Descatha, A., Cassan, P., Burgess, J. L., & Baer, M. (2017). Emergency Preparedness and Response in Occupational Setting: A Position Statement.. Frontiers in public health, 5, 251. doi:10.3389/fpubh.2017.00251
• Griffin, S., Griffin, S., Regan, T. L., Regan, T. L., Harber, P. I., Harber, P. I., Lutz, E. A., Lutz, E. A., Hu, C., Hu, C., Burgess, J. L., & Burgess, J. L. (2016). Evaluation of a fitness intervention for new firefighters: injury reduction and economic benefits. Inj Prev, 22(3), 181-8.
• Griffin, S., Poplin, G., Pollack, K., & Burgess, J. L. (2017). Implementing Risk Management to Reduce Injuries in the U.S. Fire Service. Journal of Safety Research.
• Kurzius-spencer, M., Harris, R. B., Roberge, J., Roberge, J., O'rourke, M. K., Kurzius-spencer, M., Hsu, C. H., Hartz, V., Harris, R. B., & Burgess, J. L. (2016). Relation of dietary inorganic arsenic to serum matrix metalloproteinase-9 (MMP-9) at different threshold concentrations of tap water arsenic.. Journal of exposure science & environmental epidemiology, 26(5), 445-51. doi:10.1038/jes.2014.92
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  Arsenic (As) exposure is associated with cancer, lung and cardiovascular disease, yet the mechanisms involved are not clearly understood. Elevated matrix metalloproteinase-9 (MMP-9) levels are also associated with these diseases, as well as with exposure to water As. Our objective was to evaluate the effects of dietary components of inorganic As (iAs) intake on serum MMP-9 concentration at differing levels of tap water As. In a cross-sectional study of 214 adults, dietary iAs intake was estimated from 24-h dietary recall interviews using published iAs residue data; drinking and cooking water As intake from water samples and consumption data. Aggregate iAs intake (food plus water) was associated with elevated serum MMP-9 in mixed model regression, with and without adjustment for covariates. In models stratified by tap water As, aggregate intake was a significant positive predictor of serum MMP-9 in subjects exposed to water As≤10 μg/l. Inorganic As from food alone was associated with serum MMP-9 in subjects exposed to tap water As≤3 μg/l. Exposure to iAs from food and water combined, in areas where tap water As concentration is ≤10 μg/l, may contribute to As-induced changes in a biomarker associated with toxicity.
• Mehus, A. A., Reed, R. J., Lee, V. S., Littau, S. R., Hu, C., Lutz, E. A., & Burgess, J. L. (2015). Comparison of acute health effects from exposures to diesel and biodiesel fuel emissions. Journal of Occupational and Environmental Medicine (submitted).
• Poplin, G. S., Roe, D. J., Burgess, J. L., Peate, W. F., & Harris, R. B. (2016). Fire fit: assessing comprehensive fitness and injury risk in the fire service. International archives of occupational and environmental health, 89(2), 251-9.
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  This study sought to develop a comprehensive measure of fitness that is predictive of injury risk and can be used in the fire service to assess individual-level health and fit-for-duty status.
• Jones, L., Lutz, E. A., Duncan, M., & Burgess, J. L. (2015). Respiratory protection for firefighters--evaluation of CBRN canisters for use during overhaul. Journal of occupational and environmental hygiene, 12(5), 314-22.
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  In the United States, there are approximately 366,600 structural fires each year. After visible flames are extinguished, firefighters begin the overhaul stage of firefighting to smother remaining hot spots and initiate investigations. Typically during overhaul significant ambient concentrations of chemical contaminants remain. However, previous research suggests that the use of air purifying respirators (APR) fitted with chemical, biological, radiological, and nuclear (CBRN) canisters may reduce occupational respiratory exposures. This pilot study used large-scale prescribed burns of representative structural materials to perform simultaneous, side-by-side, filtering and service-life evaluations of commercially available CBRN filters. Three types of CBRN canisters and one cartridge were challenged in repetitive post live-fire overhaul exposure tests using a sampling manifold apparatus. At a flow rate of 80 L/min, nine tests were conducted in the breathing zone for three different exposure durations (0-15 min, 0-30 min, and 0-60 min). Fifty different chemicals were identified for evaluation and results indicate that 21 of the 50 chemicals tested were in the air of the overhaul environment. Respirable particles and formaldehyde were consistently present above the American Conference of Governmental Industrial Hygienists (ACGIH®) recommended exposure level (REL) and threshold limit ceiling value (TLVc), respectively. Each filter effectively reduced concentrations for respirable particulates below the maximum recommended level. Formaldehyde was reduced, but not consistently filtered below the TLVc. These results were consistent across all exposure durations. This study indicates that, regardless of brand, CBRN filters provide protection from the vast majority of particle and gas-phase contaminants. However, due to formaldehyde breakthrough, CBRN filters do not provide complete protection during firefighter overhaul.
• Julia, P., Griffin, S., Gary, W., Peate, W., & Burgess, J. L. (2015). Cost analysis of injury claims in the fire service. International Fire Service Journal of Leadership and Management, 9.
• Kurzius-Spencer, M., Harris, R. B., Hartz, V., Roberge, J., Hsu, C., O'Rourke, M. K., & Burgess, J. L. (2015). Relation of dietary inorganic arsenic to serum matrix metalloproteinase-9 (MMP-9) at different threshold concentrations of tap water arsenic. Journal of exposure science & environmental epidemiology.
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  Arsenic (As) exposure is associated with cancer, lung and cardiovascular disease, yet the mechanisms involved are not clearly understood. Elevated matrix metalloproteinase-9 (MMP-9) levels are also associated with these diseases, as well as with exposure to water As. Our objective was to evaluate the effects of dietary components of inorganic As (iAs) intake on serum MMP-9 concentration at differing levels of tap water As. In a cross-sectional study of 214 adults, dietary iAs intake was estimated from 24-h dietary recall interviews using published iAs residue data; drinking and cooking water As intake from water samples and consumption data. Aggregate iAs intake (food plus water) was associated with elevated serum MMP-9 in mixed model regression, with and without adjustment for covariates. In models stratified by tap water As, aggregate intake was a significant positive predictor of serum MMP-9 in subjects exposed to water As≤10 μg/l. Inorganic As from food alone was associated with serum MMP-9 in subjects exposed to tap water As≤3 μg/l. Exposure to iAs from food and water combined, in areas where tap water As concentration is ≤10 μg/l, may contribute to As-induced changes in a biomarker associated with toxicity.Journal of Exposure Science and Environmental Epidemiology advance online publication, 21 January 2015; doi:10.1038/jes.2014.92.
• Lutz, E. A., Reed, R. J., Lee, V. S., & Burgess, J. L. (2015). Occupational exposures to emissions from combustion of diesel and alternative fuels in underground mining--a simulated pilot study. Journal of occupational and environmental hygiene, 12(3), D18-25.
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  Diesel fuel is commonly used for underground mining equipment, yet diesel engine exhaust is a known human carcinogen. Alternative fuels, including biodiesel, and a natural gas/diesel blend, offer the potential to reduce engine emissions and associated health effects. For this pilot study, exposure monitoring was performed in an underground mine during operation of a load-haul-dump vehicle. Use of low-sulfur diesel, 75% biodiesel/25% diesel blend (B75), and natural gas/diesel blend (GD) fuels were compared. Personal samples were collected for total and respirable diesel particulate matter (tDPM and rDPM, respectively) and total and respirable elemental and organic carbon (tEC, rEC, tOC, rOC, respectively), as well as carbon monoxide (CO), formaldehyde, acetaldehyde, naphthalene, nitric oxide (NO), and nitrogen dioxide (NO2). Compared to diesel, B75 use was associated with a 33% reduction in rDPM, reductions in rEC, tEC, and naphthalene, increased tDPM, tOC, and NO, and no change in rOC, CO, and NO2. Compared to diesel, GD was associated with a 66% reduction in rDPM and a reduction in all other exposures except CO. The alternative fuels tested both resulted in reduced rDPM, which is the basis for the current Mine Safety and Health Administration (MSHA) occupational exposure standard. Although additional study is needed with a wider variety of equipment, use of alternative fuels have the promise of reducing exposures from vehicular exhaust in underground mining settings.
• Pena, J. C., Griffin, S. C., West, G. R., Peate, W. F., & Burgess, J. L. (2015). Cost Analysis of Injury Claims in the Fire Service. International Fire Service Journal of Leadership and Management, 9.
• Poplin, G. S., Pollack, K. M., Griffin, S., Day-Nash, V., Peate, W. F., Nied, E., Gulotta, J., & Burgess, J. L. (2015). Establishing a proactive safety and health risk management system in the fire service. BMC public health, 15, 407.
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  Formalized risk management (RM) is an internationally accepted process for reducing hazards in the workplace, with defined steps including hazard scoping, risk assessment, and implementation of controls, all within an iterative process. While required for all industry in the European Union and widely used elsewhere, the United States maintains a compliance-based regulatory structure, rather than one based on systematic, risk-based methodologies. Firefighting is a hazardous profession, with high injury, illness, and fatality rates compared with other occupations, and implementation of RM programs has the potential to greatly improve firefighter safety and health; however, no descriptions of RM implementation are in the peer-reviewed literature for the North American fire service.
• Burgess, J. L., Duncan, M., Mallett, J., LaFleur, B., Littau, S., & Shiwaku, K. (2014). International Comparison of Fire Department Injuries. Fire Technology, 50(5), 1043-1059.
• Burgess, J. L., Kurzius-Spencer, M., Poplin, G. S., Littau, S. R., Kopplin, M. J., Stürup, S., Boitano, S., & Clark Lantz, R. (2014). Environmental arsenic exposure, selenium and sputum alpha-1 antitrypsin. Journal of Exposure Science and Environmental Epidemiology, 24(2), 150-155.
• Duncan, M. D., Littau, S. R., Kurzius-Spencer, M., & Burgess, J. L. (2014). Development of best practice standard operating procedures for prevention of fireground injuries. Fire Technology, 50, 1061-1076.
• Kurzius-Spencer, M., Burgess, J. L., Harris, R. B., Hartz, V., Roberge, J., Huang, S., Hsu, C., & O'Rourke, M. K. (2014). Contribution of diet to aggregate arsenic exposures - An analysis across populations. Journal of Exposure Science and Environmental Epidemiology, 24(2), 156-162.
• Poplin, G. S., Roe, D. J., Peate, W., Harris, R. B., & Burgess, J. L. (2014). The association of aerobic fitness with injuries in the fire service. American Journal of Epidemiology, 179(2), 149-155.
• White, A. G., Watts, G. S., Lu, Z., Meza-Montenegro, M. M., Lutz, E. A., Harber, P., & Burgess, J. L. (2014). Environmental arsenic exposure and microbiota in induced sputum. International Journal of Environmental Research and Public Health, 11(2), 2299-2313.
• Burgess, J. L. (2013). Arsenic compromises conducting airway epithelial barrier properties in primary mouse and immortalized human cell cultures.. PLOS ONE.
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  Sherwood CL, Liguori AE, Olsen CE, Lantz RC, Burgess JL, Boitano S. Arsenic compromises conducting airway epithelial barrier properties in primary mouse and immortalized human cell cultures. PLOS ONE (online publication).
• Burgess, J. L., Kurzius-Spencer, M., O'Rourke, M. K., Littau, S. R., Roberge, J. L., Meza-Montenegro, M. M., Gutiérrez-Millán, L. E., & Harris, R. B. (2013). Environmental arsenic exposure and serum matrix metalloproteinase-9. Journal of Exposure Science and Environmental Epidemiology, 23(2), 163-169.
• Kurzius-Spencer, M., O'Rourke, M. K., Hsu, C., Hartz, V., Harris, R. B., & Burgess, J. L. (2013). Measured versus modeled dietary arsenic and relation to urinary arsenic excretion and total exposure. Journal of Exposure Science and Environmental Epidemiology, 23(4), 442-449.
• Kurzius-spencer, M., Roberge, J., Harris, R. B., Roberge, J., O'rourke, M. K., Kurzius-spencer, M., Hartz, V., Harris, R. B., & Burgess, J. L. (2013). Dietary inorganic arsenic intake in the U.S. and relation to serum matrix metalloproteinase-9 at different threshold concentrations of tap water arsenic. ISEE Conference Abstracts, 2013(1), 3497. doi:10.1289/isee.2013.p-1-10-12
• Lee, V. S., Burgess, J. L., Sterling, C. R., & Lutz, E. A. (2013). Schistosoma mansoni: Assessment of effects of oleic acid, cercarial age and water temperature on parasite-host attraction. International Journal for Parasitology, 43(10), 837-842.
• Poplin, G. S., Miller, H., Sottile, J., Hu, C., Hill, J. R., & Burgess, J. L. (2013). Enhancing severe injury surveillance: The association between severe injury events and fatalities in US coal mines. Journal of Safety Research, 44(1), 31-35.
• Boitano, S. A., Sherwood, C. L., Burgess, J. L., & Lantz, R. C. (2012). Low-level Arsenic Alters Lung Epithelial Wound Repair. Proceedings of the American Thoracic Society.
• Burgess, J. L., Duncan, M. D., Hu, C., Littau, S. R., Caseman, D., Kurzius-Spencer, M., Davis-Gorman, G., & McDonagh, P. F. (2012). Acute cardiovascular effects of firefighting and active cooling during rehabilitation. Journal of Occupational and Environmental Medicine, 54(11), 1413-1420.
• Burgess, J. L., Kurzius-Spencer, M., Gerkin, R. D., Fleming, J. L., Peate, W. F., & Allison, M. (2012). Risk factors for subclinical atherosclerosis in firefighters. Journal of Occupational and Environmental Medicine, 54(3), 328-335.
• Lisle S. Hites, ., Brenda S. Granillo, ., Edward R. Garrison, ., Adriana D. Cimetta, ., Verena J. Serafin, ., Ralph F. Renger, ., Jessica F. Wakelee, ., & Jefferey L. Burgess, . (2012). Emergency preparedness training of tribal Community Health Representatives. Journal of Immigrant and Minority Health, 14(2), 323-329.
• Poplin, G. S., Harris, R. B., Peate, W. F., Poplin, G. S., Pollack, K. M., Peate, W. F., Harris, R. B., & Burgess, J. L. (2012). Beyond the fireground: injuries in the fire service.. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 18(4), 228-33. doi:10.1136/injuryprev-2011-040149
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  Background Although firefighting and emergency medical services are high-risk professions, few studies have identified the aetiology of injury in the fire service beyond the fireground. Methods Data were collected for work-related injuries in a medium-sized metropolitan fire department. In a descriptive study, the factors explored included the nature of injury, agent, mechanism, body location, environment, abbreviated injury scale (AIS), functional capacity index (FCI) and lost time status. Results From 2004 to 2009, the annual injury incidence rate averaged 17.7 per 100 employees. One-third of all injuries (32.9%) resulted from physical exercise activities, while patient transport, training drills and fireground operations resulted in 16.9%, 11.1% and 10.2% of injuries, respectively. For all job operations, sprains and strains were the most prevalent type of injury (40.2-85.2%), followed by contusions and lacerations (7.7-26.1%). The third most common injury was related to the conventional hazards of the individual job operation. Most injuries (n=862, 95.6%) were minor in severity, while 4.3% of injuries were classified as having some impedance of normal function (FCI 3). Moderate injuries (AIS 2) were infrequent, but comprised a greater proportion of fireground injuries (8.7%) than the other activities (1.0-4.1%); however, lost time injuries were more frequent for patient transport (46.1%) than other operations (22.0-29.1%). Conclusions Physical exercise, patient transport and training activities were responsible for a greater percentage of injuries than fireground operations. Focused efforts to improve the characterisation of risks during these more diverse set of work processes should help guide the development of salient strategies for injury prevention.
• Roberge, J., O'Rourke, M. K., Meza-Montenegro, M. M., Gutiérrez-Millán, L. E., Burgess, J. L., & Harris, R. B. (2012). Binational arsenic exposure survey: methodology and estimated arsenic intake from drinking water and urinary arsenic concentrations. International journal of environmental research and public health, 9(4), 1051-67.
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  The Binational Arsenic Exposure Survey (BAsES) was designed to evaluate probable arsenic exposures in selected areas of southern Arizona and northern Mexico, two regions with known elevated levels of arsenic in groundwater reserves. This paper describes the methodology of BAsES and the relationship between estimated arsenic intake from beverages and arsenic output in urine. Households from eight communities were selected for their varying groundwater arsenic concentrations in Arizona, USA and Sonora, Mexico. Adults responded to questionnaires and provided dietary information. A first morning urine void and water from all household drinking sources were collected. Associations between urinary arsenic concentration (total, organic, inorganic) and estimated level of arsenic consumed from water and other beverages were evaluated through crude associations and by random effects models. Median estimated total arsenic intake from beverages among participants from Arizona communities ranged from 1.7 to 14.1 µg/day compared to 0.6 to 3.4 µg/day among those from Mexico communities. In contrast, median urinary inorganic arsenic concentrations were greatest among participants from Hermosillo, Mexico (6.2 µg/L) whereas a high of 2.0 µg/L was found among participants from Ajo, Arizona. Estimated arsenic intake from drinking water was associated with urinary total arsenic concentration (p < 0.001), urinary inorganic arsenic concentration (p < 0.001), and urinary sum of species (p < 0.001). Urinary arsenic concentrations increased between 7% and 12% for each one percent increase in arsenic consumed from drinking water. Variability in arsenic intake from beverages and urinary arsenic output yielded counter intuitive results. Estimated intake of arsenic from all beverages was greatest among Arizonans yet participants in Mexico had higher urinary total and inorganic arsenic concentrations. Other contributors to urinary arsenic concentrations should be evaluated.
• Burgess, J. L., Wong, S. S., Sun, N. N., Fastje, C. D., Witten, M. L., Lantz, R. C., Lu, B., Sherrill, D. L., & Gerard, C. J. (2011). Role of neprilysin in airway inflammation induced by diesel exhaust emissions. Research report (Health Effects Institute).
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  In this study, we examined the role of neprilysin (NEP), a key membrane-bound endopeptidase, in the inflammatory response induced by diesel exhaust emissions (DEE) in the airways through a number of approaches: in vitro, animal, and controlled human exposure. Our specific aims were (1) to examine the role of NEP in inflammatory injury induced by diesel exhaust particles (DEP) using Nep-intact (wild-type) and Nep-null mice; (2) to examine which components of DEP are associated with NEP downregulation in vitro; (3) to determine the molecular impact of DEP exposure and decreased NEP expression on airway epithelial cells' gene expression in vitro, using a combination of RNA interference (RNAi) and microarray approaches; and (4) to evaluate the effects on NEP activity of human exposure to DEE. We report four main results: First, we found that exposure of normal mice to DEP consisting of standard reference material (SRM) 2975 via intratracheal installation can downregulate NEP expression in a concentration-dependent manner. The changes were accompanied by increases in the number of macrophages and epithelial cells, as well as proinflammatory cytokines, examined in bronchoalveolar lavage (BAL) fluid and cells. Nep-null mice displayed increased and/or additional inflammatory responses when compared with wild-type mice, especially in response to exposure to the higher dose of DEP that we used. These in vivo findings suggest that loss of NEP in mice could cause increased susceptibility to injury or exacerbate inflammatory responses after DEP exposure via release of specific cytokines from the lungs. Second, we found evidence, using in vitro studies, that downregulation of NEP by DEP in cultured human epithelial BEAS-2B cells was mostly attributable to DEP-adsorbed organic compounds, whereas the carbonaceous core and transition metal components of DEP had little or no effect on NEP messenger RNA (mRNA) expression. This NEP downregulation was not a specific response to DEP or its contents because the change also occurred after exposure to urban dust (SRM 1649a), which differs in physical and chemical composition from DEP. Third, we also collected the transcriptome profiles of the concentration-effects of SRM 2975 in cultured BEAS-2B cells through a 2 X 3 factorial design. DEP exposure upregulated 151 genes and downregulated 59 genes. Cells with decreased NEP expression (accomplished by transfecting an NEP-specific small interfering RNA [siRNA]) substantially altered the expression of genes (upregulating 17 and downregulating 14) associated with DNA/protein binding, calcium channel activities, and the cascade of intracellular signaling by cytokines. Data generated from the combined RNAi and microarray approaches revealed that there is a complex molecular cascade mediated by NEP in different subcellular compartments, possibly influencing the inflammatory response. Fourth, in a controlled human exposure study, we observed significant increases in soluble NEP in sputum after acute exposure to DEE, with an average net increase of 31%. We speculate that the change in NEP activity in sputum, if confirmed in larger epidemiologic investigations at ambient exposure levels to DEE, may provide a useful endpoint and promote insight into the mechanism of DEE-induced airway alterations.
• Cara L. Sherwood, ., Lantz, R. C., Burgess, J. L., & Boitano, S. A. (2011). Arsenic alters ATP-dependent Ca 2+ signaling in human airway epithelial cell wound response. Toxicological Sciences, 121(1), 191-206.
• Poplin, G. S., Harris, R. B., Pollack, K. M., Peate, W. F., & Burgess, J. L. (2011). Beyond the fireground: Injuries in the fire service. Injury Prevention.
• Burgess, J. L., Granillo, A. B., Renger, R., & Wakelee, J. (2010). Utilization of the Native American Talking Circle to teach incident command system to tribal community health representatives. Journal of community health, 35(6).
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  The public health workforce is diverse and encompasses a wide range of professions. For tribal communities, the Community Health Representative (CHR) is a public health paraprofessional whose role as a community health educator and health advocate has expanded to become an integral part of the health delivery system of most tribes. CHRs possess a unique set of skills and cultural awareness that make them an essential first responder on tribal land. As a result of their distinctive qualities they have the capability of effectively mobilizing communities during times of crisis and can have a significant impact on the communities' response to a local incident. Although public health emergency preparedness training is a priority of federal, state, local and tribal public health agencies, much of the training currently available is not tailored to meet the unique traits of CHRs. Much of the emergency preparedness training is standardized, such as the Federal Emergency Management Agency (FEMA) Training Programs, and does not take into account the inherent cultural traditions of some of the intended target audience. This paper reports on the use of the Native American Talking Circle format as a culturally appropriate method to teach the Incident Command System (ICS). The results of the evaluation suggest the talking format circle is well received and can significantly improve the understanding of ICS roles. The limitations of the assessment instrument and the cultural adaptations at producing changes in the understanding of ICS history and concepts are discussed. Possible solutions to these limitations are provided.
• Wong, S. S., Sun, N. N., Miller, H. B., Witten, M. L., & Burgess, J. L. (2010). Acute changes in sputum collected from exposed human subjects in mining conditions. Inhalation Toxicology, 22(6), 479-485.
• Kurzius-Spencer, M., Foster, K., Littau, S. R., Richey, K. J., Clark, B. M., Sherrill, D., Boitano, S. A., Caruso, D. M., & Burgess, J. L. (2009). Tracheobronchial protease inhibitors, body surface area burns, and mortality in smoke inhalation. Journal of Burn Care and Research, 30(5), 824-831.
• Sherwood, C. L., Olsen, C. E., Liguori, A. E., Lantz, R. C., Burgess, J. L., & Boitano, S. (2009). Arsenic alters P2 receptor-dependent Ca2+ signaling in human airway epithelial cells. The FASEB Journal, 23.
• Sherwood, C. L., Olsen, C. E., Liguori, A. E., Lantz, R. C., Burgess, J. L., & Boitano, S. (2009). Arsenic alters tight junction expression, distribution and function in human airway epithelial cells. The FASEB Journal, 23.
• Thrasher, D. L., Derau, K. v., & Burgess, J. L. (2009). Health effects from reported exposure to methamphetamine labs: A poison center-based study. Journal of Medical Toxicology, 5(4), 200-204.
• Berran Yucesoy, ., Margaret Kurzius-Spencer, ., Victor J. Johnson, ., Kara Fluharty, ., Michael L. Kashon, ., Stefano Guerra, ., Michael I. Luster, ., & Jefferey L. Burgess, . (2008). Association of cytokine gene polymorphisms with rate of decline in lung function. Journal of Occupational and Environmental Medicine, 50(6), 642-648.
• Burgess, J. L., Kurzius-Spencer, M., Foster, K., Littau, S. R., Richey, K. J., Clark, B. M., Sherrill, D. L., Goodman, R. B., & Boitano, S. A. (2008). Tracheobronchial markers of lung injury in smoke inhalation victims. Journal of burn care & research : official publication of the American Burn Association, 29(2).
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  Although smoke inhalation injury victims frequently develop severe hypoxemia and are at increased risk of acute respiratory distress syndrome (ARDS), no early prognostic tests are currently available. The objectives were to determine early longitudinal changes in tracheobronchial fluid inflammatory markers and assess the value of initial concentrations as predictors of subsequent lung injury. Partial pressure of arterial oxygen (Pao2) and the fraction of inspired oxygen (Fio2) were recorded approximately every 6 hours from intubated smoke inhalation victims admitted to a regional burn center. Tracheobronchial suction fluid was collected every 2 hours and assayed for interleukins (IL-1beta, -8, and -10), tumor necrosis factor-alpha, transforming growth factor-beta1, soluble Fas ligand (sFasL), and complement factor 5a. Temporal trends in marker concentrations during 36 hours and the relations between initial concentrations and lowest Pao2/Fio2 or ARDS within 72 hours were assessed using random coefficients modeling and cross-sectional analysis. In 21 subjects with tracheobronchial samples collected within 6.5 hours of intubation, 14 (66.7%) developed acute hypoxemia (Pao2/Fio2 < or =200) within 72 hours of exposure and nine (42.9%) developed ARDS, as defined by the American-European consensus conference on ARDS. IL-8 increased sharply in the first 6.5 hours postexposure (P < .001), and IL-1beta in the first 6.1 hours (P < .001). No significant temporal trends in IL-10, tumor necrosis factor-alpha, transforming growth factor-beta1, sFasL, or complement factor 5a were found. Only initial IL-8 was associated with increased Pao2/Fio2 (P = .013) and with a minimum Pao2/Fio2 >200 (P = .042) during 72 hours. In smoke inhalation victims, tracheobronchial IL-1beta and IL-8 increase rapidly and high initial IL-8 may predict improved oxygenation.
• Maria M. Meza-Montenegro, ., Michael J. Kopplin, ., Jefferey L. Burgess, ., & A. Jay Gandolfi, . (2008). Urinary arsenic methylation profile in children exposed to low arsenic levels through drinking water. Toxicological and Environmental Chemistry, 90(5), 957-970.
• Olsen, C. E., Liguori, A. E., Zong, Y., Lantz, R. C., Burgess, J. L., & Boitano, S. A. (2008). Arsenic upregulates MMP-9 and inhibits wound repair in human airway epithelial cells. American Journal of Physiology - Lung Cellular and Molecular Physiology, 295(2), L293-L302.
• Poplin, G. S., Miller, H. B., Ranger-Moore, J., Bofinger, C. M., Kurzius-Spencer, M., Harris, R. B., & Burgess, J. L. (2008). International evaluation of injury rates in coal mining: A comparison of risk and compliance-based regulatory approaches. Safety Science, 46(8), 1196-1204.
• Robinson, M. S., Anthony, T. R., Littau, S. R., Herckes, P., Nelson, X., Poplin, G. S., & Burgess, J. L. (2008). Occupational PAH exposures during prescribed pile burns. Annals of Occupational Hygiene, 52(6), 497-508.
• Wong, S. S., Wong, S. S., Witten, M. L., Sun, N. N., Lantz, R. C., & Burgess, J. L. (2008). METHYLATION STATUS OF NEUTRAL ENDOPEPTIDASE GENES DOWN-REGULATED BY DIESEL EXHAUST PARTICULATES IN HUMAN AIRWAY EPITHELIUM. The FASEB Journal, 22.
• Zong, Y., Olsen, C. E., Liguori, A. E., Lantz, R. C., Burgess, J. L., & Boitano, S. (2008). Low-dose arsenic inhibits wound repair, upregulates MMP-9 and alters Ca2+ signaling in human airway epithelial cells. The FASEB Journal, 22.
• Anthony, T. R., Joggerst, P., James, L., Burgess, J. L., Leonard, S. S., & Shogren, E. S. (2007). Method development study for APR cartridge evaluation in fire overhaul exposures. Annals of Occupational Hygiene, 51(8), 703-716.
• Burgess, J. L., Fleming, J. E., Mulenga, E. M., Josyula, A. B., Hysong, T. A., Joggerst, P. J., Kurzius-Spencer, M., & Miller, H. B. (2007). Acute changes in sputum IL-10 following underground exposure to diesel exhaust. Clinical Toxicology, 45(3), 255-260.
• Jefferey L. Burgess, . (2007). Editorial on "exposure assessment of a mercury spill in a Nevada school - 2004". Clinical Toxicology, 45(4), 431.
• Jefferey L. Burgess, ., Maria M. Meza, ., Arun B. Josyula, ., Gerald S. Poplin, ., Michael J. Kopplin, ., Hannah E. McClellen, ., Stefan Stürup, ., & R. Clark Lantz, . (2007). Environmental arsenic exposure and urinary 8-OHdG in Arizona and Sonora. Clinical Toxicology, 45(5), 490-498.
• Josyula, A. B., Kurzius-Spencer, M., Littau, S. R., Yucesoy, B., Fleming, J., & Burgess, J. L. (2007). Cytokine genotype and phenotype effects on lung function decline in firefighters. Journal of Occupational and Environmental Medicine, 49(3), 282-288.
• R. Clark Lantz, ., Brandon J. Lynch, ., Scott Boitano, ., Gerald S. Poplin, ., Sally Littau, ., George Tsaprailis, ., & Jefferey L. Burgess, . (2007). Pulmonary biomarkers based on alterations in protein expression after exposure to arsenic. Environmental Health Perspectives, 115(4), 586-591.
• Wong, S. S., Wong, S. S., Witten, M. L., Sun, N. N., Lantz, R. C., Hersh, L. B., & Burgess, J. L. (2007). Importance of neutral endopeptidase in epithelial response to diesel particulate exposure. The FASEB Journal, 21(5). doi:10.1096/fasebj.21.5.a407-c
• Andrew, A. S., Burgess, J. L., Meza, M. M., Demidenko, E., Waugh, M. G., Hamilton, J. W., & Karagas, M. R. (2006). Arsenic exposure is associated with decreased DNA repair in vitro and in individuals exposed to drinking water arsenic. Environmental Health Perspectives, 114(8), 1193-1198.
• Dart, R. C., Bevelaqua, A., DeAtley, C., Sidell, F., Goldfrank, L., Madsen, J., Alcorta, R., Keim, M., Auf der Heide, E., Joyce, S., Shannon, M., Burgess, J. L., Kirk, M., Henretig, F., Thomas, R., Geller, R., Bronstein, A. C., Eitzen, E., Kilbourne, E., , Fenton, D., et al. (2006). Countering chemical agents.. JEMS : a journal of emergency medical services, 31(12), 36-41.
• Josyula, A. B., McClellen, H., Hysong, T. A., Kurzius-Spencer, M., Poplin, G. S., Stürup, S., & Burgess, J. L. (2006). Reduction in urinary arsenic with bottled-water intervention. Journal of Health, Population and Nutrition, 24(3), 298-304.
• Josyula, A. B., Poplin, G. S., Kurzius-Spencer, M., McClellen, H. E., Kopplin, M. J., Stürup, S., Lantz, R. C., & Burgess, J. L. (2006). Environmental arsenic exposure and sputum metalloproteinase concentrations. Environmental Research, 102(3), 283-290.
• Miller, H. B., Sinkala, T., Renger, R. F., Peacock, E. M., Tabor, J. A., & Burgess, J. L. (2006). Identifying antecedent conditions responsible for the high rate of mining injuries in Zambia. International Journal of Occupational and Environmental Health, 12(4), 329-339.
• Derby, M. P., McNally, J., Ranger-Moore, J., Hulette, L., Villar, R., Hysong, T., MacNeill, E., Lebowitz, M., & Burgess, J. (2005). Poison Control Center--based syndromic surveillance for foodborne illness. MMWR. Morbidity and mortality weekly report, 54 Suppl, 35-40.
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  This retrospective study evaluated the usefulness of a poison control center (PCC) data collection system in Tucson, Arizona for early detection of foodborne disease outbreaks.
• Mulenga, E. M., Miller, H. B., Sinkala, T., Hysong, T. A., & Burgess, J. L. (2005). Silicosis and tuberculosis in Zambian miners. International Journal of Occupational and Environmental Health, 11(3), 259-262.
• Poplin, G. S., Miller, H. D., Nintz, P. J., Martini, L., & Burgess, J. L. (2005). Dermatitis in the mining industry: Incidence, sources, and time loss. Archives of Environmental and Occupational Health, 60(2), 77-85.
• Burgess, J. L., Fierro, M. A., Lantz, R. C., Hysong, T. A., Fleming, J. E., Gerkin, R., Hnizdo, E., Conley, S. M., & Klimecki, W. (2004). Longitudinal decline in lung function: Evaluation of interleukin-10 genetic polymorphisms in firefighters. Journal of Occupational and Environmental Medicine, 46(10), 1013-1022.
• Maria Mercedes Meza, ., Michael J. Kopplin, ., Jefferey L. Burgess, ., & A. Jay Gandolfi, . (2004). Arsenic drinking water exposure and urinary excretion among adults in the Yaqui Valley, Sonora, Mexico. Environmental Research, 96(2), 119-126.
• Burgess, J. L., Witten, M. L., Nanson, C. J., Hysong, T. A., Sherrill, D. L., Quan, S. F., Gerkin, R., & Bernard, A. M. (2003). Serum pneumoproteins: A cross-sectional comparison of firefighters and police. American Journal of Industrial Medicine, 44(3), 246-253.
• Hysong, T. A., Burgess, J. L., Cebrián Garcia, M. E., & O'Rourke, M. K. (2003). House dust and inorganic urinary arsenic in two Arizona mining towns. Journal of Exposure Analysis and Environmental Epidemiology, 13(3), 211-218.
• Burgess, J. L., Kovalchick, D. F., Siegel, E. M., Hysong, T. A., & McCurdy, S. A. (2002). Medical surveillance of clandestine drug laboratory investigators. Journal of Occupational and Environmental Medicine, 44(2), 184-189.
• Burgess, J. L., Nanson, C. J., Hysong, T. A., Gerkin, R., Witten, M. L., & Lantz, R. C. (2002). Rapid decline in sputum IL-10 concentration following occupational smoke exposure. Inhalation Toxicology, 14(2), 133-140.
• Kovalchick, D. F., Burgess, J. L., Kyes, K. B., Lymp, J. F., Russo, J. E., Roy-Byrne, P. P., & Brodkin, C. A. (2002). Psychological effects of hazardous materials exposures. Psychosomatic Medicine, 64(5), 841-846.
• Burgess, J. L. (2001). Phosphine exposure from a methamphetamine laboratory investigation. Journal of Toxicology - Clinical Toxicology, 39(2), 165-168.
• Burgess, J. L., Kovalchick, D. F., Harter, L., Kyes, K. B., Lymp, J. F., & Brodkin, C. A. (2001). Hazardous materials events: Evaluation of transport to health care facility and evacuation decisions. American Journal of Emergency Medicine, 19(2), 99-105.
• Burgess, J. L., Kovalchick, D. F., Lymp, J. F., Kyes, K. B., Robertson, W. O., & Brodkin, C. A. (2001). Risk factors for adverse health effects following hazardous materials incidents. Journal of Occupational and Environmental Medicine, 43(6), 558-566.
• Burgess, J. L., Nanson, C. J., Bolstad-Johnson, D. M., Gerkin, R., Hyson, T. A., Lantz, R. C., Sherrill, D. L., Crutchfield, C. D., Quan, S. F., Bernard, A. M., & Witten, M. L. (2001). Adverse respiratory effects following overhaul in firefighters. Journal of Occupational and Environmental Medicine, 43(5), 467-473.
• Nanson, C. J., Burgess, J. L., Robin, M., & Bernard, A. M. (2001). Exercise alters serum pneumoprotein concentrations. Respiration Physiology, 127(2-3), 259-265.
• Burgess, J. L., Kovalchick, D. F., Harter, L., Kyes, K. B., & Thompson, J. N. (2000). Hazardous materials events: An industrial comparison. Journal of Occupational and Environmental Medicine, 42(5), 546-553.
• Burgess, J. L., Morrissey, B., Keifer, M. C., & Robertson, W. O. (2000). Fumigant-related illnesses: Washington State's five-year experience. Journal of Toxicology - Clinical Toxicology, 38(1), 7-14.
• D.M. Bolstad-Johnson, ., J.L. Burgess, ., C.D. Crutchfield, ., S. Storment, ., R. Gerkin, ., & J.R. Wilson, . (2000). Characterization of firefighter exposures during fire overhaul. American Industrial Hygiene Association Journal, 61(5), 636-641.
• Burgess, J. L. (1999). Hospital evacuations due to hazardous materials incidents. American Journal of Emergency Medicine, 17(1), 50-52.
• Burgess, J. L., Brodkin, C. A., Daniell, W. E., Pappas, G. P., Keifer, M. C., Stover, B. D., Edland, S. D., & Barnhart, S. (1999). Longitudinal decline in measured firefighter single-breath diffusing capacity of carbon monoxide values: A respiratory surveillance dilemma. American Journal of Respiratory and Critical Care Medicine, 159(1), 119-124.
• Burgess, J. L., Kirk, M., Borron, S. W., & Cisek, J. (1999). Emergency department hazardous materials protocol for contaminated patients. Annals of Emergency Medicine, 34(2), 205-212.
• Burgess, J. L., Kovalchick, D. F., Kyes, K. B., Thompson, J. N., & Barnhart, S. (1999). Hyperventilation following a large-scale hazardous-materials incident. International Journal of Occupational and Environmental Health, 5(3), 194-197.
• Luderer, U., Burgess, J. L., Polifka, J. E., & Robertson, W. O. (1999). Calls on reproductive and developmental toxicants to a regional Poison Center. Veterinary and Human Toxicology, 41(1), 42-46.
• Burgess, J. L., Hamner, A. P., & Robertson, W. O. (1998). Sulfhemoglobinemia after dermal application of DMSO. Veterinary and Human Toxicology, 40(2), 87-89.
• Elko, C. j., Burgess, J. L., & Robertson, W. O. (1998). Zolpidem-associated hallucinations and serotonin reuptake inhibition: A possible interaction. Journal of Toxicology - Clinical Toxicology, 36(3), 195-203.
• Robertson, W. O., Hamner, A. P., & Burgess, J. L. (1998). SULFHEMOGLOBINEMIA AFTER DERMAL APPLICATION OF DMSO. Veterinary and Human Toxicology, 40(2), 87-89.
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  A 43-y-old Caucasian female applied 4 ounces of dimethyl sulfoxide (DMSO) to her lower abdomen for treatment of interstitial cystitis. Within 24 h she developed fatigue, cyanosis and dyspnea with mild exertion. She sought medical attention 10 d later, at which time initial laboratory tests revealed a methemoglobin level of 47%. Two doses of 1 mg methylene blue/kg i.v. were given without significant improvement in either her cyanosis or methemoglobin level. Repeat analysis the day following admission using an outside lab demonstrated a sulfhemoglobin level of 6.2% and a methemoglobin level of < 0.1%. No prior reports have associated sulfhemoglobin formation with DMSO application. Carbon monoxide-oximetry may falsely identify sulfhemoglobin as methemoglobin; sulfhemoglobinemia should be considered in cases of methemoglobinemia refractory to methylene blue therapy.
• Stover, B. D., Pappas, G. P., Keifer, M. C., Edland, S. D., Daniell, W. E., Burgess, J. L., Brodkin, C. A., & Barnhart, S. (1998). LONGITUDINAL DECLINE IN FIREFIGHTER DLCO MEASUREMENTS: A RESPIRATORY SURVEILLANCE DILEMMA. Journal of Occupational and Environmental Medicine, 40(11), 1031. doi:10.1097/00043764-199811000-00048
• Burgess, J. L., Blackmon, G. M., Brodkin, C. A., & Robertson, W. O. (1997). Hospital preparedness for hazardous materials incidents and treatment of contaminated patients. Western Journal of Medicine, 167(6), 387-391.
• Burgess, J. L., Keifer, M. C., Barnhart, S., Richardson, M., & Robertson, W. O. (1997). Hazardous materials exposure information service: Development, analysis, and medical implications. Annals of Emergency Medicine, 29(2), 248-254.
• Burgess, J. L., Pappas, G. P., & Robertson, W. O. (1997). Hazardous materials incidents: The Washington Poison Center experience and approach to exposure assessment. Journal of Occupational and Environmental Medicine, 39(8), 760-766.
• Burgess, J. L., Barnhart, S., & Checkoway, H. (1996). Investigating clandestine drug laboratories: Adverse medical effects in law enforcement personnel. American Journal of Industrial Medicine, 30(4), 488-494.
• Burgess, J. L., & Crutchfield, C. D. (1995). Quantitative respirator fit tests of Tucson fire fighters and measurement of negative pressure excursions during exertion. Applied Occupational and Environmental Hygiene, 10(1), 29-36.
• Burgess, J. L., & Crutchfield, C. D. (1995). Tucson fire fighter exposure to products of combustion: A risk assessment. Applied Occupational and Environmental Hygiene, 10(1), 37-42.
• Morrissey, B., Burgess, J. L., & Robertson, W. O. (1995). Washington's experience and recommendations re: Anticoagulant rodenticides. Veterinary and Human Toxicology, 37(4), 362-363.
• Burgess, J. L., Bernstein, J. N., & Hurlbut, K. (1994). Aldicarb poisoning. A case report with prolonged cholinesterase inhibition and improvement after pralidoxime therapy. Archives of internal medicine, 154(2), 221-4.
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  Aldicarb is the most potent of the commercially available carbamate pesticides and is an unusual source of acute human poisonings. We present the case of a 43-year-old man exposed to aldicarb who developed severe cholinergic symptoms and progressive weakness requiring intubation for 5 days. Both his red blood cell cholinesterase and plasma pseudocholinesterase levels were depressed for a minimum of 44 hours. He demonstrated neuromuscular improvement concurrent with pralidoxime administration. The pertinent medical literature on aldicarb poisoning is reviewed.
• Burgess, J. L., Dart, R. C., Egen, N. B., & Mayersohn, M. (1992). Effects of constriction bands on rattlesnake venom absorption: A pharmacokinetic study. Annals of Emergency Medicine, 21(9), 1086-1093.
• Burgess, J. L., & Dart, R. C. (1991). Snake venom coagulopathy: use and abuse of blood products in the treatment of pit viper envenomation. Annals of emergency medicine, 20(7), 795-801.
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  Coagulopathies are commonly encountered in victims of pit viper envenomation. In the majority of patients these defects improve with administration of antivenin. However, blood products are often transfused based on arbitrary criteria and with significant risk to the patient. This article documents the effectiveness and risks of antivenin administration and the risks of blood product transfusion. We recommend that blood products not be used except for clearly defined clinical indications.

Proceedings Publications

• Burgess, J. L., Reed, R. J., Brown, L. D., & Wilson, L. P. (2020, June). Gamification of Hazard Recognition in Mining with a Tabletop Card Game. In Advances in Human Factors in Simulation and Modeling, 1296.
• Haynes, P. L., Medici, K., Grandner, M., & Burgess, J. L. (2016, June). Ambient light exposure is positively associated with calmness in mental health care providers. In SLEEP.
• Blair, A., Blask, D. E., Bratveit, M., Brock, T., Burgess, J. L., Costa, G., Davis, S., Demers, P. A., Hansen, J., Haus, E., Landrigan, P. J., Lemasters, G. K., Levi, F., Merletti, F., Portier, C. J., Pukkala, E., Schernhammer, E. S., Steenland, K., Stevens, R. G., , Vermeulen, R., et al. (2010). Painting, firefighting, and shiftwork. In IARC.

Presentations

• Mitchell, C., Hollister, J., Fisher, J. M., Beitel, S., Burgess, J. L., Lutrick, K., & Ellingson, K. (2024, April). Serum Concentrations of Per-and Polyfluoroalkyl Substances Among Firefighters in the Arizona Healthcare, Emergency Responder, and Other Essential Worker Study — Arizona, July 27, 2020–April 15, 2023. 2024 Annual Epidemic Intelligence Service (EIS) Conference. Atlanta, GA.
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  This abstract is a finalist for the Singal environmental and occupational health award.The presenter was Cedar Mitchell.
• Williams, . C., Granillo, A. B., Burgess, J. L., & Ross, B. J. (2020, February). Sharing Critical Controls. SME National Conference. Denver: SME.
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  Presentation and paper update on NIOSH research on sharing critical controls.
• Caban-Martinez, A., Jung, A., Littau, S., Zhou, J., Jeong, K., Bertke, S., Morrison, P., Fahy, R., Horn, G., Griffin, S., Jahnke, S., Jacobs, E. T., Solle, N., Grant, C., Fent, K., & Burgess, J. L. (2018, Summer). Design of and Data Collection in a National Multi-Site Fire Fighter Cancer Cohort Study. American Public Health Association. San Diego, CA.

Poster Presentations

• Victory, K., Reynolds, K. A., Cabrera, N. L., Larson, D., Burgess, J. L., & Beamer, P. (2014, April). Comparison of Chemical and Microbial Contaminants in Tap, Bottled and Vended Water in a U.S.-Mexico Border Community. UA Poster Forum. Tucson, AZ.
• Victory, K., Reynolds, K. A., Cabrera, N. L., Larson, D., Latura, J., Burgess, J. L., & Beamer, P. I. (2014, October). Comparison of Chemical and Microbial Contaminants in tap, Bottled, and Vended Water in a U.S.-Mexico Border Community. International Society of Exposure Science. Cincinnati, OH.