PhD, University of Cincinnati, 2024, Pharmacy: Pharmaceutical Sciences

Commercial sunscreen products have been developed to protect human skin from ultraviolet radiation (UVR) with the use of chemical ingredients known as ultraviolet filters (UVFs). Sunscreens are important in protecting human health by preventing skin cancer. However, there have been several scientific publications investigating the potential impact of UVFs on environmental health in recent years. In response to the growing concern, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a review consensus report on this topic and one knowledge gap identified is the need to further research environmental emissions of UVFs. This doctoral research set out to investigate two variables important to environmental emissions estimates of sunscreen UVFs: the amount applied to the skin (i.e., application thickness) and the amount released from the skin (i.e., release percentage). The hypothesis that was tested is the assumption of 100% sunscreen and UVF release from the skin is not representative of real-world conditions and leads to over-estimates of direct environmental emissions of UVFs from sunscreens. Three different studies were designed and executed to test this hypothesis. A large-scale web-based survey was developed and fielded to participants with the aim to measure sunscreen application aided by a visual reference and determine a more representative overall value for the United States (US) population. In the end, three online surveys and one home usage study were conducted. Results of this research support the inference that consumers are not applying the US Food and Drug Administration recommended application of 2.0 mg/cm2 and individual sunscreen application is highly variable. Next, two sunscreen rinse-off and release experiments were conducted. An in vivo rinse-off experiment using human volunteers aimed to determine a baseline UVF release percentage. The data from these experiments determined the average UVF release percentage wa (open full item for complete abstract)

Committee: Harshita Kumari Ph.D. (Committee Chair); Kavssery Ananthapadmanabhan ENG.SC.D. (Committee Member); Carys Mitchelmore Ph.D. (Committee Member); Kevin Li Ph.D. (Committee Member); James Coleman Ph.D. (Committee Member) Subjects: Pharmaceuticals

MPH, University of Cincinnati, 2023, Medicine: Biostatistics

Introduction: The Fernald Medical Monitoring Program (FMMP) was established to monitor the health of residents living in the area surrounding the Fernald Feed Materials Production Center (FMPC). Beginning in 1991, this program involved comprehensive physical examinations as well as multiple biospecimen collections. After the program ceased operations in 2008, the medical monitoring program became the Fernald Community Cohort (FCC), and as a result, a variety of laboratory data, medical histories, and lifetime uranium exposure estimates have been made available for research. Kidney diseases have been studied in this cohort, but specific analysis has not been conducted using lifetime exposure estimates and laboratory measures of renal health. Uranium has been associated with damage to the kidneys, but studies have struggled to establish a conclusive link between level of airborne exposure and renal function. The primary objective of this project is to investigate whether level of uranium exposure is associated with laboratory indicators of kidney function, namely serum glucose, serum creatinine, urine creatinine, and microalbumin. Methods: This study featured a cross-sectional quantitative approach using a sample of 8,235 eligible adult participants in the FCC. Upon enrollment, urine and blood samples were collected from participants in the program. An approximation of airborne uranium exposure was available for each participant using an algorithm provided by the Center for Disease Control and Prevention (CDC). Participants were also separated into three distinct groups by this exposure estimate. Descriptive statistics were generated for the full sample, as well as distributions of serum glucose, serum creatinine, urine creatinine, and microalbumin by age, sex, and exposure group. Linear regression and logistic regression models were created to investigate potential relationships between laboratory data and exposure, controlling for covariates of age and sex. Results (open full item for complete abstract)

Committee: Wei-Wen Hsu Ph.D. (Committee Member); Susan Pinney Ph.D. (Committee Chair) Subjects: Public Health

MPH, University of Cincinnati, 2022, Medicine: Environmental Public Health

Background: Ecological grief is a psychological response to environmental loss caused by natural and man-made events. The prevalence of ecological grief has been found to be especially pronounced in people who hold close relationships with the environment. The Fernald site, near Cincinnati, Ohio, is a former US Department of Energy nuclear fuel processing plant. During its operation from 1951-1989, releases from the site resulted in environmental contamination of radon, uranium, and various other organic and inorganic chemicals. The air, water, and soil were all found to be contaminated which consequently impacted the health and safety of people living on or in close proximity to the site and also challenged the long-term emotional wellbeing of nearby residents. The Fernald Community Cohort (FCC) was a cohort of 9,782 people who participated in the Fernald Medical Surveillance Program from 1990-2008. The purpose of this study was to examine the degree of ecological grief reported by the participants of the FCC and to discern the degree of ecological grief among this community by residential proximity to the plant, level of uranium exposure, and cancer diagnosis. Methods: As part of the ongoing FCC surveying, in 2020, participants were invited to complete a brief questionnaire of four questions to assess the impact of ecological grief among FCC participants. Data that was collected from the FCC was utilized in this study for variables such as demographics, cancer diagnosis, uranium exposure, and proximity to the Feed Material Production Center (FMPC). Descriptive statistics were calculated for demographic and main study variables using IMB SPSS (v. 28). Results: In the sample, 55.3% of respondents reported moderate to severe ecological grief. The model (n=3,737) was tested with one degree of freedom, with the program variable of uranium concentration accounting for most (2.8%) of the variance, followed by ecological grief (2.1%), and ever having a cancer diagnosi (open full item for complete abstract)

Committee: Rachael Nolan Ph.D. M.P.H. (Committee Member); Tiina Reponen Ph.D. (Committee Member) Subjects: Public Health

MS, University of Cincinnati, 2022, Arts and Sciences: Biological Sciences

Chemical pollution has become a ubiquitous stressor on aquatic ecosystems by interacting with abiotic and biotic factors to produce complex responses in exposed organisms. While regulations have curbed the release of lethal concentrations, sublethal concentrations of chemical pollutants can also interact with environmental factors and alter the fitness of exposed individuals. One environmental factor, water depth, is constantly variable as climate change increases the severity and frequency of storms and length of droughts across the United States. While the impacts of other abiotic factors on toxicity have been explored, there is a significant knowledge gap in understanding how water depth influences an organism's response to sublethal concentrations of chemicals. This study explores how three different water depths impact behavioral and transcriptomic responses of fathead minnow larvae (P. promelas) exposed to two distinct contaminants, bifenthrin and copper sulfate, to understand how water depth interacts with chemical exposure, larvae were exposed to either bifenthrin or copper sulfate at one of three depths for 24 hours. Behavioral response to alternating photoperiods and differential gene expression were used as endpoints to assess sensitivity and the nature of the toxic response across the three water depths. For both chemical exposures, the individuals exposed in shallow water depths were able to maintain normal behavior and had negligible amounts of differentially expressed genes indicating a lowered sensitivity to the chemical. There were altered behavioral responses and increased numbers of differentially expressed genes found in the medium and deep exposure groups for both chemicals. For bifenthrin, the nature of the differentially expressed genes indicated a difference in how the medium and deep exposure groups are responding compared to the shallow exposure group. For copper, a response could only be detected in the medium and deep exposure groups. Dif (open full item for complete abstract)

Committee: Latonya Jackson Ph.D. (Committee Member); Kathleen Grogan Ph.D. (Committee Member); Adam Biales Ph.D. (Committee Member) Subjects: Biology

PhD, University of Cincinnati, 2021, Medicine: Epidemiology (Environmental Health)

Background: Manganese (Mn) toxicity is most often a result of industrial point sources, as Mn compounds are emitted from metal processing factories. Environmental Mn exposure has been linked to deficits in neuromotor function. Marietta, Ohio is home to the longest operating ferromanganese refinery, the top source of ambient Mn in North America. In this community-based longitudinal cohort study of children living near the refinery, we investigate the relationship between childhood and adolescent exposure to Mn and adolescent neuromotor function. Methods: A literature review was conducted to evaluate the current body of knowledge surrounding pediatric Mn exposure and neuromotor function. Participants in the Communities Actively Researching Exposures Study (CARES) provided biological specimens of blood, hair and toenails at a childhood visit conducted at ages 7-9 years. Blood was analyzed for manganese (Mn), lead (Pb) and serum cotinine, a marker of environmental tobacco smoke. Hair and toenails were analyzed for Mn. Study participants returned during adolescent years 13-17 for collection of biological specimens of blood and hair and evaluation of neuromotor function through postural balance testing. Blood was analyzed for Mn, Pb and serum cotinine and hair for Mn. Geometric means (GM) and geometric standard deviations (GSD) were calculated for biomarker concentrations and arithmetic means and standard deviations (SD) and frequencies for sociodemographic information of participants. Multivariable regression models were employed to examine the relationships between childhood and adolescent Mn exposure and adolescent postural balance, adjusting for covariates. Secondary analyses were conducted to visually examine plots with fitted splines and gender-by-Mn interaction effects on postural balance. Results: The CARES participants who completed adolescent postural balance testing were 54% female and 98% Caucasian. The mean age was 16 years old (range 13-17). (open full item for complete abstract)

Committee: Amit Bhattacharya Ph.D. (Committee Chair); Heidi Sucharew (Committee Member); Erin Haynes Dr.P.H. (Committee Member); Kelly Brunst Ph.D. (Committee Chair) Subjects: Epidemiology

Doctor of Philosophy, The Ohio State University, 2020, Communication

Overcoming audience resistance is an important and lasting topic in communication research. Theories conceptualizing the self as the driver of various media processes, including selection, processing, and effects, can offer a unified account for audience resistance across communication domains and provide important guidance for message design in communication campaigns and interventions. This dissertation focused on the role of the self-improvement motive in media processes and posited that, due to its ability to orient individuals towards changes in their self-concepts, this motivation can encourage the selection and processing of beneficial but self-threatening messages, as well as produce positive outcomes post-exposure. Theoretical propositions were advanced based on the SESAM (Selective Exposure Self- and Affect Management) model and the literature on the self-improvement motive. The SESAM model posits that the working self and affect combined would determine a self-related motive, which then directs selective exposure behaviors and message processing of mediated social comparison targets. Specifically, the self-improvement motive is expected to prompt media users to select portrayals of upward comparison targets to learn and improve, resulting in more positive affect and self-concept after exposure. Study 1 added to the original model by examining the potential predictors of the self-improvement motive, including domain importance, perceived discrepancy, and perceived attainability (proposition 1); and testing whether priming a working self-concept in conjunction to the self-improvement motive would lead to selection of upward comparison targets in the same life domain (proposition 2). The results showed little support for these predictions. Perceived discrepancy interacted with perceived attainability to produce different levels of the self-improvement motive as expected. However, the manipulation did not prompt stronger selective exposure of upward compar (open full item for complete abstract)

Committee: Silvia Knobloch_Westerwick Ph.D. (Committee Chair); Emily Moyer-Gusé Ph.D. (Committee Member); Hyunyi Cho Ph.D. (Committee Member); Graham Dixon Ph.D. (Committee Member) Subjects: Communication

PhD, University of Cincinnati, 2019, Medicine: Industrial Hygiene (Environmental Health)

The goal of the exposure assessment process is to accurately define the exposure distribution for workers over a certain period of time in order to identify the resulting potential risk to employees' health or well-being. The main objectives of this research were to investigate the effect of local environmental factors on occupational exposure with the consideration of different contaminants and to determine the impact of these factors on the performance of different direct reading instruments. Overall, this dissertation consists of three studies (A-C). In study A, the current occupational health risk assessment methodologies that have been developed to assess human health risks in the petroleum refining industry are outlined and compared. Three general categories of health risk assessment methods that have routine use in the petroleum sector include process safety management, quantitative exposure and risk assessment management tools, and qualitative risk ranking tools. Published health assessment methods for oil and gas, and, chemical industries lack transparency, often have unclear validation, and the majority of the available methods are too complicated and time intensive for routine scenario assessment use. In study B, four micro-environmental factors, wind speed and direction, distance to the emission source, and worker posture were investigated in a laboratory simulation. Methane was used in a simulated setting of an oil refinery maintenance task involving replacing a blind in a 4-inch line. Gas concentration was measured at the breathing zone (BZ) with the Gas-Rover. This simulation study suggests that the local environmental factors have a significant effect on the level of gas concentration at the worker BZ. Air blowing from the side direction reduced average concentrations by the most significant percentage (96%) compared to the baseline, followed by the front direction (68%) then the swirled air movement by (63%) reduction level. Air blowing fr (open full item for complete abstract)

Committee: Kermit Davis Ph.D. (Committee Chair); Susan Arnold Ph.D. (Committee Member); Thomas Lentz Ph.D. (Committee Member); Michael Maier Ph.D. (Committee Member); Marepalli Rao Ph.D. (Committee Member) Subjects: Occupational Safety

Doctor of Philosophy, The Ohio State University, 2019, Public Health

Background: Occupational exposure to airborne chemical agents is a concern for thousands of workers in the United States. Regulatory limits determine the level at which workers may be exposed to chemical agents, and exposure over these limits may indicate a risk for health hazards. The main purpose of this study was to evaluate exposure to specific airborne chemical agents by industry group, by occupation group, and over time using occupational exposure monitoring data in order to determine potential groups of workers that should be targeted for intervention and future research. In addition, this study used an auto-coding program in order to code the free text job descriptions to standardized occupation codes for the first time, as only industry was provided as a standardized code within the applied dataset. Methods: The study employed the Occupational Safety and Health Administration (OSHA) Integrated Management Information System (IMIS) and Occupational Safety and Health Information System (OIS) databases to evaluate personal air monitoring samples taken from 1979 through 2015. The OSHA IMIS/OIS is the largest occupational exposure database in the United States. Analyses were conducted in SAS. Exceedance fractions over an agent's threshold limit value (TLV) or permissible exposure limit (PEL) were calculated through frequency analyses and linear regression was used to determine changes in geometric mean of exposure level over time. Statistical procedures included using logistic regression and mixed-model analyses to obtain odds ratios for the likelihood of exposure over an agent's TLV or PEL in comparison to other industry or occupation groups. The NIOSH Industry and Occupation Computerized Coding System (NIOCCS) version 3.0 was used to auto-code free text job descriptions into standardized occupation codes. Results: Examination of benzene, toluene, ethyl benzene, and xylene (BTEX) occupational exposure indicated that manufacturing industry groups inclu (open full item for complete abstract)

Committee: Michael Bisesi PhD (Advisor); John Crawford PhD (Advisor); Carolyn Sommerich PhD (Committee Member); Christopher Weghorst PhD (Committee Member); Olorunfemi Adetona PhD (Committee Member) Subjects: Occupational Health; Public Health

Master of Science (MS), Bowling Green State University, 2019, Biological Sciences

In flowing environments, the degree of turbulent flow determines the movement and distribution of chemicals. Variation in flow alters the patchiness of toxicant plumes within a stream ecosystem. This patchiness translates into variability in exposure pulses for organisms encountering the toxic plume. Throughout a stream, the processes that give rise to chemical plume structure will vary as a function of local flow characteristics. This research examines the influence of toxicant mode of entry and stream flow velocity on the spatiotemporal patterning of exposure. Two introduction treatments were evaluated: one mimicking groundwater and the other mimicking runoff. The influence of flow regime was examined through the comparison of models constructed under two stream flow velocities. Concentrations of a tracer molecule were recorded using an electrochemical monitoring system. From these localized, direct measurements, geographic information systems (GIS) were used to model exposure throughout the stream. Conceptualizing exposure as a series of toxicant pulses, exposure can be defined using a variety of chemical peak characteristics. Three-dimensional, layered maps were constructed defining exposure as the integrated area of toxicant peaks, the magnitude of peaks, and peak frequency. Differences in the spatial and temporal patterning of exposure were apparent both within treatments and between treatments. No two definitions of exposure yielded the same exposure distributions for any treatment. These models demonstrate that distribution of chemical exposure throughout a stream ecosystem is linked to both toxicant mode of introduction and stream hydrodynamics. Furthermore, these results demonstrate that optimal exposure modeling relies on first defining exposure.

Committee: Paul Moore Dr. (Advisor); Mamadou Coulibaly Dr. (Committee Member); Louise Stevenson Dr. (Committee Member) Subjects: Biology; Ecology; Hydrology

Bachelor of Science, Wittenberg University, 2015, Biology

Atrazine, the second most utilized herbicide in the United States, has been shown to disrupt endocrine systems in a variety of organisms. Studies have shown atrazine to cause male frogs to become hermaphrodites, as well as inflict chromosomal damage to the ovary cells of hamsters and induce false pregnancies in rats. However, other studies have refuted these results, showing that legal limits of atrazine have negligible effects on exposed organisms. The topic of atrazine use has recently become controversial, especially as the product benefits the U.S. agricultural market by billions of dollars every year. Most studies performed on the effects of atrazine exposure have been conducted on frogs, so these results are well documented. However, zebrafish, a vertebrate model organism, has been less studied. By exposing male zebrafish to an environmentally relevant concentration of atrazine, this study aimed to elucidate the effects of atrazine on the expression of aromatase. Aromatase is the enzyme responsible for both sex determination and conversion of testosterone to estrogen in zebrafish, though the mechanism by which it is synthesized is poorly understood. Results showed that atrazine exposed organisms did not exhibit aromatase expression, though non-exposed organisms did. These results may be due to experimental errors, issues with the experimental design (in that the atrazine concentration used and/or the exposure period were not sufficient), or the possibility that atrazine does not influence the expression of aromatase, but instead, affects the activity of the enzyme. Further research is recommended to elucidate the effects of environmentally relevant concentrations of atrazine on male zebrafish.

Committee: Michelle McWhorter Dr. (Advisor); Ruth Hoff Dr. (Committee Member); Amber Burgett Dr. (Committee Member) Subjects: Biology; Environmental Science

MPH, University of Cincinnati, 2015, Medicine: Epidemiology

BACKGROUND: Improving technology has allowed researchers to detect ever smaller amounts of environmental toxins in blood, serum and urine. Occasionally, participants are found to have concentrations well above national averages. There are few systems of support in place for participants to whom these results have been returned, and no guidelines for researchers or community physicians concerning how to address participants' concerns. This study aims to assess whether or not community physicians are ready and willing to assist their patients who have participated in biomonitoring studies. METHODS: The study group recruited 100 internists, and 100 pediatricians selected via multiple online directories to ensure the greatest coverage of the Greater Cincinnati area. A survey consisting of two scenarios, with 8 or 9 multiple choice questions each, was mailed to these 200 community physicians. The scenarios presented were an 11 year old female with extremely high urinary phthalates, and a 55 year old male with extremely high urinary cadmium. STATISTICAL ANALYSIS: Descriptive statistics were calculated for each scenario separately for strata of physician specialty, gender, and age range. RESULTS: The majority of physicians surveyed indicated that they would like to receive the information about their patient's exposure levels (93.4%). Nearly all indicated that they did not have the knowledge base to offer their patient any guidance or treatment, and that they would require additional information. Many of the comments left on the surveys asked for the researchers to provide informational material to the physicians along with their patient's results, so that they might be able to better serve the patient. DISCUSSION: Based on the large percentage of physicians who indicated a desire to receive this kind of information, we believe this topic warrants further study in order to address the lack of guidance for researchers and community physicians.

Committee: Susan Pinney Ph.D. (Committee Chair); Frank Biro M.D. (Committee Member); Jun Ying Ph.D. (Committee Member) Subjects: Environmental Health

PhD, University of Cincinnati, 2010, Medicine : Molecular and Developmental Biology

In the United States, over 30 million Americans suffer from asthma. More than 9 million of these asthmatics are children. Asthma is a complex genetic disease involving a multifaceted relationship between genetic background and environmental exposures. Among those genes consistently linked to asthma are the glutathione S-transferase (GST) family of genes, a group of phase II detoxification enzymes and redox regulators responsible for host defense against many environmental toxins and reactive oxygen species (ROS) including those found associated with diesel exhaust particles (DEP), environmental tobacco smoke (ETS), and mold. GSTPi is the predominant GST enzyme expressed in the lung. Many epidemiological studies have implicated a single nucleotide polymorphism in the GSTPi gene, GSTP1 Ile105Val (rs1695), as a predictor for asthma. While evidence supports a strong role for GSTPi in allergic airway disease, very little is known about the regulation of GSTPi in asthma and its contribution to oxidative stress in asthma. The studies in this dissertation focus on determining GST activity regulation during allergic inflammation and how it contributes to the development of asthma. We demonstrate that children in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) birth cohort (N=570) carrying the GSTP1 Val105 allele, an allele associated with decreased GST enzyme activity, are significantly likely to wheeze when exposed to DEP, ETS, or mold. Exposure to multiple allergens increased the risk for wheezing independently of the GSTP1 genotype, suggesting that multiple environmental exposures can overwhelm the genetic effect. In order to address the regulation of GSTPi expression and total GST activity, we utilized mouse models of asthma. We demonstrate that allergen or interleukin 13 (IL-13) treatment attenuates GSTPi expression and total GST activity in the lung, although IL-13 is not required for this down-regulation. In addition, these studies demonstrate that I (open full item for complete abstract)

Committee: Gurjit Hershey MD, PhD (Committee Chair); Chris Karp MD (Committee Member); Robert Kahn MD, MPH (Committee Member); Timothy Lecras PhD (Committee Member); Fred Finkelman MD (Committee Member) Subjects: Molecular Biology

PhD, University of Cincinnati, 2009, Medicine : Neuroscience/Medical Science Scholars Interdisiplinary

INTRODUCTION: Lead is a potent environmental toxicant. Childhood lead exposure is associated with persistent cognitive and behavioral deficiencies, suggesting underlying neuroanatomic changes. This dissertation is an investigation of the effects of childhood lead exposure on young adult gray matter volume and white matter structure. METHODS: We investigated a subset of the long-running Cincinnati Lead Study, a prospective birth cohort study investigating the effects of environmental lead exposure on a primarily black, urban inner-city cohort. Participants received 23 serial assessments of blood lead concentration during childhood, high-resolution volumetric magnetic resonance imaging at approximately 21 years of age, and diffusion tensor imaging at approximately 24 years of age. Associations between gray matter volume and mean childhood blood lead, and yearly mean blood lead levels from years 1 to 6, were investigated by adjusted voxel-wise multiple regression analysis using voxel-based morphometry (VBM) techniques. Associations between mean childhood lead levels and white matter diffusivity changes were investigated using adjusted multiple regression analyses. RESULTS: Mean childhood lead levels were associated with significant adult gray matter volume loss, particularly in the frontal lobes, and particularly in men. Analysis of yearly mean blood lead levels revealed that blood levels later in childhood were more strongly associated with adult gray matter volume loss than earlier blood lead levels. The most extensive and significant regions of lead-associated gray matter volume loss were found in the frontal lobes of men associated with lead levels measured later at 5 and 6 years of age. Investigation of white matter diffusivity changes by diffusion tensor imaging analysis revealed widespread changes in fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. The observed patterns of diffusivity changes was consistent with signific (open full item for complete abstract)

Committee: Kim Cecil PhD (Advisor); Caleb Adler MD (Committee Member); James Herman PhD (Committee Member); Bruce Lanphear MD MPH (Committee Member); M. Douglas Ris PhD (Committee Member); Stephen Woods PhD (Committee Member) Subjects: Health; Neurology; Radiology

Doctor of Philosophy, The Ohio State University, 2012, Public Health

Background. Considerable controversy and uncertainty surround the reproductive health threat from exposure to bisphenol A (BPA). This common chemical to which most humans are exposed has long been known to have estrogenic properties, but much more research is needed on the effects of BPA exposure during pregnancy. Objectives. To address this uncertainty, we investigated exposure to BPA and associations with birth outcomes with particular focus on the vulnerable subpopulation of low-income, African-American women in the first trimester of pregnancy. Methods. We conducted cross-sectional analyses of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the U.S. population, examining relations between demographic and occupational factors and urinary BPA concentrations. Logistic regression was used to model the relation between current urinary BPA concentration and reproductive history. This secondary data analysis was complemented by a clinic-based primary data collection effort where we enrolled low-income African-American women in the first trimester of pregnancy (n=16) to compare urinary BPA concentrations to self-reported contact with potential sources of BPA and to assess feasibility of these methods for a future longitudinal study of prenatal BPA exposure and birth outcomes. Results. Women of reproductive age in NHANES had increased odds of having delivered a low birth weight baby (3% per 10% increase in urinary BPA; p=0.046) and decreased odds of having delivered a high birth weight baby (5% per 10% increase in urinary BPA; p=0.02). History of ever being pregnant, ever giving birth to a live infant, ever experiencing a pregnancy loss, or ever having been diagnosed with gestational diabetes were not associated with BPA exposure (p≥.39). U.S. workers (male and female) employed in the "retail-food stores" industry had higher urinary BPA concentrations than workers in other industries (p=0.05). With 11 of 16 samples (open full item for complete abstract)

Committee: Timothy J. Buckley PhD (Advisor); Courtney D. Lynch PhD (Committee Member); Rebecca R. Andridge PhD (Committee Member); John M. Crawford PhD (Committee Member) Subjects: Environmental Health; Epidemiology; Public Health