On the Trail of Early Molecular Signals Contributing to Lung Cancer L Lung cancer is the leading cause of cancer death in the United States. However, the molecular mechanisms that trigger airway epithelial cells to become cancerous have not been well understood. About 80 percent of patients diagnosed with lung cancer die within one year because the disease is not detected until it has reached an advanced stage. “We know that exposure to environmental pollutants, such as cigarette smoke, injures the lung’s epithelial cells and can also trigger changes in cellular functions that can lead to development of lung cancer,” explains Associate Professor and molecular and cellular physiologist Dr. Sekhar Reddy. “If we better understood these early molecular mechanisms controlling epithelial cell hyperplasia and squamous metaplasia, which have been considered to be among the precancerous cellular changes, we might be able to prevent the development of lung cancer.” In a major step towards understanding how air pollutants injure the lung and trigger a cascade of molecular events leading to lung cancer, Reddy is looking at gene expression and regulation during toxicant-induced airway epithelial injury and repair. He found that FRA-1 transcription factor, a member of the activator protein 1 (AP-1) family, induces the expression of airway squamous metaplastic marker, SPRR1B gene. FRA-1 is overexpressed in a variety of human tumors, and contributes to tumor progression. In addition to mitogens, various toxicants and carcinogens persistently induce FRA-1 expression. Reddy, therefore, believes that FRA-1 plays key roles in cigarette smoke-induced respiratory pathogenesis, especially lung cancer development. After discovering that exposure to cigarette smoke caused a marked upregulation of FRA-1, he began investigating the mechanisms that control the upregulation of FRA-1 by cigarette smoke and tumor promoters in noncancerous and cancerous airway epithelial cells. His lab recently found that cigarette smoke stimulates FRA-1 expression via EGFR and PI3-kinase mediated signaling in non-cancerous airway epithelial cells. Several recent studies show that aberrant activation of EGFR and PI3K signaling occurs during tumorogenesis. His research is currently focused on identifying the key effector proteins that control a high-level expression of FRA-1 in tumors and the effects of carcinogens on those factors. He is employing mouse genetic models to specifically delete the FRA-1 gene in lung epithelial cells to determine whether this transcription factor is required for the initiation and/or progression of lung cancer in vivo. Reddy wants to understand ultimately how tobacco smoke and other carcinogens in air pollutants cause airway epithelial cells to become tumorigenic. Dr. Sekhar Reddy wants to understand ultimately how tobacco smoke and other carcinogens in air pollutants cause airway epithelial cells to become tumorigenic. Under the Microscope Research News of the Department of Environmental Health Sciences Team Player: Physiologist Extends the Boundaries of His Research A According to Clarke Tankersley, PhD, it’s not a long-term career plan that keeps him satisfied: “You just plan to come in tomorrow. You bring the same energy you did twenty years ago and hope, in the end, that you had an influence.” More than two decades after coming to the Department of Environmental Health Sciences as a Laboratory Coordinator, his enthusiasm is still in ready supply. Now, as an Associate Professor in the Division on Physiology, the opportunity to share his excitement and energy with students, staff, and other faculty adds yet another motivation to his work. In a time of increasing specialization, Tankersley finds enjoyment in constantly broadening his interests. He praises the intense focus some researchers have for a topic. That track — attacking a single question until it has given up its secrets — has produced amazing results, here at Hopkins and around the world. But it’s not the system he prefers to work in. “Diversity is what really interests me,” he says. Investigations into air pollution, lung genetics and ALS (Lou Gehrig’s Disease) can run concurrently in his laboratory. Though they may not appear linked on the surface, these topics are part of an integrated examination of lung physiology. That Environmental Health Sciences nourishes all of these topics is a testament to, and perhaps a glimpse into, the strength of the Department. These topics hardly delineate the whole scope of the Department; but even if his interests widened further, he would find collaborators already inhouse. This unique opportunity to interact with other thinkers is part of what brings Tankersley in to work every day. He draws inspiration from being among this group, who he describes as the “smartest people on the scene.” Watching these “great minds” go through the intellectual processes of their research keeps him inspired and coming back for more. To be able to collaborate with these outstanding faculty and students is an opportunity that doesn’t exist anywhere else. Never one to put himself on a pedestal, he says, “There’s nothing shining about me. I’m just doing what I set out to do, and having fun doing it.” Having so much fun, in fact, that he has stayed at Hopkins more than twenty years, despite looking forward to a small-college career for himself as he worked toward his PhD. A small school, a faculty position, and perhaps coaching lacrosse: that was the five-year plan. Tankersley sees remaining at Hopkins as an incredible opening of possibilities beyond that plan. The opportunities and collaborations at Hopkins are second to none. He now has the pleasure, with his laboratory team, of exploring his own research interests as they catch his fancy. Besides he’s managed to coach lacrosse for his three children in his off-time. The idea of a team is the foundation of his view of work in public health. Tankersley may now be captain of a squad, as he describes it, but he knows he wouldn’t be in the game at all without his team. From other research faculty, through student investigators and support staff, he acknowledges his debt to the Department’s team members. They are crucial to him continuing his research. Research that won’t be narrowing in focus any time soon. As Tankersley says, “The impact of the environment on human health is the central question of public health.” It’s a safe bet that he’ll be exploring a broad range of those effects in the coming years. A Match Made….on the Farm! The work of recent PhD and the Center for a Livable Future prove mutually beneficial F Following your path, with a combination of determination, hard work, and openness to the thread that guides you, sometimes bears fruit in serendipitous ways. Consider, for example, Amy Chapin, newlyminted PhD and the Center for a Livable Future (CLF), both in the Department of Environmental Health Sciences. found in Chapin a capable researcher as well as an effective communicator to bridge the perspectives of the scientific, policy and advocacy communities on issues central to the work of CLF. Chapin’s research interests dovetailed nicely with CLF’s Spira/Grace project that addresses the impacts of industrial animal production on the environment, rural communities, and human and animal health. She serves as Research Director for the project and provides technical assistance on project activities as well as writing resource documents. A native of Columbia, Maryland, Chapin majored in biology at the University of Maryland, College Park. She considered medical school but applied to the Yale School of Public Health when she learned about the field of environmental health sciences. At Yale, she volunteered with an environmental protection clinic made up of law, forestry and public health students working on projects with organizations around the country. Her clinic work for the Kerr Center for Sustainable Agriculture became the basis for her master’s thesis. Amy Chapin works closely with CLF Project Director Shawn Amy’s doctoral studies at Johns Hopkins were supported for her four years by the Howard Hughes Medical Institute’s Predoctoral Program in Biological Science. In addition, several of her research projects and ensuing publications were supported by CLF Directed Research or Innovation Grants — specifically her work McKenzie, providing technical assistance on project with arsenic resistance After graduation, she activities as well as writing resource documents. in campylopacter on was accepted to law poultry products and school but deferred to airborne multi-drug resistant bacteria from become an environmental epidemiologist at the concentrated swine operations. “These are emerging Maryland Department of Health and Mental Hygiene. issues,” says Schwabb, “which are often challenging to Monitoring pfiesteria outbreaks, oil spills, and blueget funded. CLF has been instrumental in support of green algal blooms in the Chesapeake Bay kept her both applied and fundamental science for Chapin and busy. However, the lukewarm response by the State other students.” agency to concerns of a western Maryland community about health impacts from a concentrated Without a crystal ball it is difficult to say what the swine facility helped Amy decide to hone her scientific future holds for this promising new graduate, but if skills rather than go to law school. She chose JHSPH past is prologue, look out! over Harvard for her doctoral studies because Kellogg Schwabb, PhD, who became her advisor, was building the Center for Water and Health here. That decision For more information on the also brought Chapin to the Center for a Livable activities of the Center for a Future where she found a host of shared interests. Livable Future, please visit The Center for a Livable Future (CLF), whose www.jhsph.edu/Environment subject is the complex interrelationships among diet, food production, environment and human health, Spring Cleaning Indoor Air Pollution W We’ve all heard about indoor air pollution. The marketing blitz concerning air-purifying machines does indicate we are wising up. We recently sat down with Timothy J. Buckley, PhD, MHS, an associate professor of Environmental Health Sciences, about what indoor air pollution is composed of and whether we should worry about the air inside our dwellings. Any others sources of indoor pollution? Buckley: The third big category is consumer products, and even the materials our houses are made of. Plywood and particle board, for instance, release formaldehyde fumes and other aldehydes. Carpeting and carpet adhesives, solvents, shoe polish, degreasers, air fresheners—all are sources of pollution. Some people even store gasoline and pesticides indoors, which of course will off-gas harmful fumes as well. How bad is indoor air pollution, compared to the pollution outside? Buckley: Indoor air pollution can be many times higher than what’s going on outside. If you think about it, our indoor air almost always has to be worse because the outdoor pollution provides the baseline that’s automatically going to be added on to whatever pollution is inside. Your lowest indoor pollution levels can’t be any lower than the levels of pollution outside. Can these noxious fumes combine with one another and create an additive effect? Buckley: Yes, especially in some urban areas where you’ve got high background air pollution outside, poor quality housing that’s maybe letting in water, a high prevalence of smoking. These pollutants do pile on for a double, triple, even quadruple whammy. But we don’t know much about how they play off of one another, their synergistic interactions—that’s an area ripe for new research. But it seems like we hear a lot more about outdoor pollution than we do about indoor. Buckley: Yes, that’s probably because most epidemiologic research has focused on outdoor pollution. But, on the other hand, now we’re telling people that indoor air pollution is much more serious a problem. So there’s a little schizophrenia about our handling of indoor pollution. The good news is, we have some control over indoor pollution. We can modify our indoor contributions. What are the major indoor contributors to pollution? Buckley: Number one, cigarette smoke. If there’s one thing to change, that would be it. Cigarette smoke contains pollutants across the whole spectrum of harmful compounds: particulate matter, carbon monoxide, volatile organic compounds (VOCs), nitrogen oxides—these compounds will overwhelm almost any other pollutants that seep in from outdoors. What about other sources of fire or combustion besides cigarettes? Buckley: Yes, burning candles or incense—and cooking meals—all can generate a lot of unhealthy airborne particulate matter. What about mold? Buckley: Yes, molds and fungi are a big concern. We could classify these as biological contaminants of the home, along with other allergens such as pet dander, dust, mouse-urine proteins and dust mites. Obviously, these too become more of a problem when windows and doors are shut tight during the winter— although winter’s low humidity is protective against this class of pollutants. Continued on next page Any other chemicals—in packaging, say? Buckley: In fact, the consumer products I was just listing bring to mind another set of compounds that are causing growing concern: the flame retardants and stain repellants in our upholstery and clothing. The flame retardants are called PBDEs, for polybrominated diphenyl ethers, and their use in consumer goods has increased exponentially in recent years. Another group of chemicals, called perfluorinated hydrocarbons, are also applied to upholstery fabric, to keep spills from soaking in and to make stains come out more easily. These non-stick chemicals, believe it or not, are also added to the insides of pizza boxes to keep our pizzas from adhering to the package. If these PBDEs and PFH are dangerous, why are they allowed on and in our bodies? Buckley: Chemically, PBDEs look a little like some other organic chemicals that we do know are quite toxic. And they are persistent, so we know their levels are constantly increasing in our indoor environments. But right now we don’t understand their toxicity very well—or whether they even are toxic. Our increasing ability to detect the presence of such chemicals in the human body has outstripped our ability to determine whether they are harming us. Are they a health threat? We don’t know. We know that new classes of chemicals are being brought into our homes and that our exposures to them are likely quite high. In fact, a five-year study of nursing mothers in Sweden has detected an exponential rise in PBDE levels in the mothers’ milk, and thus in their babies. Then shouldn’t we be doing something about this exposure right now? Buckley: There’s something called the precautionary principle, which asks: If you don’t know anything about the toxicity of something, should you assume it’s toxic and act accordingly? It’s a controversial question in public health right now because, on the one hand, could there perhaps be a link between some ubiquitous household chemical and the skyrocketing incidences of asthma and autism? On the other hand, if we invoke the precautionary principle in this case and ban flame retardants, there’s going to be a trade-off, a price tag for consumers because we’ll be losing the chemicals that protect us from fire injury and death. One solution is the type of air purifier that uses the so-called HEPA filters—high-efficiency particulate air filters. I have had experience with this type of air filter and they do work. I haven’t seen the data on the other type of air cleaners, those that use ionization. So what would you say to the energyconscious homeowner trying to save money on the heating bill? Buckley: You must be smart about indoor air pollution at the same time you’re being smart about energy conservation. Sealing up windows and doors saves money on the bill, it’s true, and there wouldn’t be a big downside to that if you’ve got no indoor sources of pollution. But who doesn’t cook, and burn candles, and bring home the dry-cleaning and household products, and buy new clothes? A low airexchange rate means that whatever fumes are in there are going to stay there and that we’re going to have to inhale them. Faculty Fellows Named to Center for Excellence in Environmental Public Health Tracking A Associate Professor of Environmental Health Sciences Norma Kanarek, PhD was among four faculty members recently named fellows of the Center for Excellence in Environmental Public Health Tracking at the Johns Hopkins Bloomberg School of Public Health. While senior scientist at the Public Health Foundation (PHF) of Washington, D.C., she participated in the design and development of the Community Health Status Indicators Project—an effort that has produced a community health profile for every U.S. county. Along with the Centers for Disease Control and PHF, she is working to update these community profiles and make them available once again to local planners, officials, community advocates and academics. She is also integrating epidemiologic strategies and etiologic information about cancer with statistical tools to assess local excesses of disease or other poor outcomes. Student Highlights Student Highlights of the Department of Environmental Health Sciences All Creatures Great and Small Seeking Alternatives to Animal Testing in Research A At the end of a stressful day, PhD student Renee Gardner likes to sit silently with her two cats to decompress. Respect for animals has long guided her viewpoint on animal welfare and her concern with responsibility toward animal testing in research. “I believe we have a moral obligation not to cause unnecessary pain and distress to animals,” explains Gardner. When Gardner was initially looking at PhD programs, Hopkins grabbed her attention due to the Johns Hopkins Center for Alternatives to Animal Testing (CAAT) residing within the Department of Environmental Health Sciences. The Center has worked with scientists since 1981 to find new methods to replace the use of laboratory animals in experiments, reduce the number of animals tested, and refine necessary tests to eliminate pain and distress. The Three Rs—replace, reduce, refine—have become the cornerstone of the Center’s mission. “I couldn’t wait to sit down with the Center Director Dr. Alan Goldberg to learn about CAAT’s work,” says Gardner. “Following that discussion, I knew Johns Hopkins was Renee Gardner (right) is investigating scientific alternatives to the use of animals to progress her research with Dr. Ellen Silbergeld (left) on the role of mercury in the development of autoimmune disease. where I wanted to go for graduate school.” With help from a grant from the American Society for the Prevention of Cruelty to Animals, Gardner is investigating scientific alternatives to the use of animals. She is using the one-year renewable grant to progress her current research with Dr. Ellen Silbergeld on the role of mercury in the development of autoimmune disease. “To date, researchers have used animals to test the impact of toxic compounds,” explains Gardner. “My ultimate aim is to explore alternative testing methods that can be used in place of current animal tests.” Gardner’s interest is timely. The European Union’s proposed chemical safety legislation, known as REACH, could require producers and users of chemicals to register and test approximately 30,000 chemicals currently in commercial use within the European Union. Such tests will include screening for developmental toxicity, which is complex and expensive in terms of animal use and scientific resources. “Unfortunately, there are currently no tests that enable high volumes of chemicals to be tested quickly and without the use of animals, yet there are tens of thousands of chemicals that need to be tested under REACH proposals,” adds Alan Goldberg, PhD. CAAT, along with international collaboration, recently launched a new program of scientific meetings to identify alternatives to the use of animals in developmental neurotoxicity (DNT) testing. The program, called TestSmart DNT, will bring together research scientists, policy analysts, regulators, academics, industry representatives, and public interest groups to examine potential alternatives to the use of animals. continued on page 7 Continued from page 6 Gardner credits, in part, her undergraduate degrees in philosophy and cell biology with her interest in animal testing alternatives. The two degrees facilitated an interaction between the two disciplines, leading her to consider scientific research in the context of philosophy and ask herself if there is a better, safer, more humane future for people and animals. “In time,” she concludes, “I believe the scientific community will embrace the three Rs as a challenge and not a threat.” Sa ve the Da te Sav Date WHA T DNT Conference: WHAT TestSmart Creating a Humane and Efficient Approach to Developmental Neurotoxicity Testing WHEN March 13-15, 2006 WHERE Hyatt Regency Reston, Reston, Virginia For more information, visit http://caat.jhsph.edu/dnt Norovirus Found To Cause Traveler’s Diarrhea Study of U.S. Travelers to Mexico and Guatemala Found 65 Percent Prevalence Rate A A majority of traveler’s diarrhea cases among U.S. travelers to Mexico and Guatemala were attributed to Norovirus, a common cause of nonbacterial gastroenteritis outbreaks usually associated with developed countries, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health and other institutions. The researchers found that the longer travelers stayed at their destination, the more likely they were to contract Norovirus infections. The study was published in the March 2005 issue of the Journal of Clinical Microbiology. “Noroviruses are known to be a major cause of food- and waterborne gastronteritis outbreaks in domestic and unique settings, such as cruise ships, and also have been documented among military groups during deployment overseas. However, few studies have investigated the prevalence of Norovirus infection among civilians traveling from industrialized to developing countries,” said Kellogg J. Schwab, PhD, corresponding author of the study and an assistant professor in the Department of Environmental Health Sciences. He explained that Noroviruses often are not considered in studies of traveler’s diarrhea because, until recently, molecular detection methods for these viruses have not been readily available in laboratories in the United States or other countries. Researchers examined stool samples from 34 individuals who experienced traveler’s diarrhea during trips to Antigua, Guatemala or Cuernavaca, Mexico, for Noroviruses, as well as for bacterial and protozoan pathogens. Sixty-five percent of individuals in the study had at least one stool sample positive for Norovirus. “Noroviruses are known to be a major cause of food- and waterborne gastronteritis outbreaks,” says Assistant Professor Kellogg Schwab, PhD. Amy Chapin, first author of the study, noted that 11 Noroviruspositive stool samples also were positive for E. coli, a leading bacterial cause of traveler’s diarrhea, thus indicating that dual infections among individuals experiencing traveler’s diarrhea may be more common than previously thought. The authors said that further research into the role of Noroviruses in traveler’s diarrhea is warranted. The simple, inexpensive molecular diagnostic techniques used in this study to identify Norovirus-positive stool samples could serve to facilitate future Norovirus-related research in developing countries. Educational Roundup Educational Program News from the Department of Environmental Health Sciences Recruitment Weekend Draws Top Students O On a blustery, cold weekend in February, the Department of Environmental Health Sciences welcomed prospective graduate students to Recruitment Weekend. This year’s Recruitment Weekend was held on February 4 & 5. The annual event provides selected PhD applicants with the opportunity to explore graduate opportunities within the Department. Prospective students meet current students and faculty, learn about the research activities taking place across the Department, and familiarize themselves with career opportunities in environmental health science. “Recruitment Weekend is the culmination of months of working to find the best students to join the Department,” explains Pam Derrick, Director of Educational Programs. “The weekend gives those students a chance to make a wise decision on graduate programs within our Department.” Students who would like to be considered for Recruitment Weekend must submit their application to the Department by January 15th. EHS Showcase Promotes Academic Program C College faculty and advisors from across Maryland attended the first annual EHS Showcase, held January 26, 2005. The day began with a luncheon, providing guests with the opportunity to interact informally with departmental faculty. The showcase was designed to provide guests with a comprehensive overview of graduate programs offered by the Department. Activities included several research presentations, laboratory and campus tours, and discussions with current faculty and students. The day concluded with student presentations and a reception. If you would like to be included in the Department’s next showcase or would like information on our academic programs, please contact Pamela Derrick, Director of Educational Programs at (410) 502-5918 or [email protected]. The Urb Blurb News from the Johns Hopkins Center in Urban Environmental Health Center Researcher’s Article Among Most Cited I In 2002, Shyam Biswal, PhD, assistant professor in Cancer Research, Biswal and his colleagues described the the Department of Environmental Health Sciences at use of “gene chip” technology to decipher the the Johns Hopkins Bloomberg School of Public complex network of pathways that are turned on by Health, published the groundbreaking article the activation of Nrf2 (Nuclear factor E2 p45-related “Identification of Nrf2-Regulated Genes Induced by the factor 2) in response to anticancer agents such as Chemopreventive Agent sulforaphane. The gene chip Sulforaphane by Oligonucleotide allowed researchers to Microarray.” The article monitor the complex identified how specific genes interactions of thousands of and enzymes enable proteins on a whole genome sulforaphane, a compound rather than one at time. The in broccoli and other study was also the first gene vegetables, to prevent cancer profiling analysis of a and remove toxins from cancer-preventing agent cells. Since then, Biswal’s using “gene chip” article has been highly cited technology. The researchers by other researchers, placing said the findings provided a it in the top 1 percent better understanding of the among the most cited body’s defense mechanisms articles in its subject and could lead to the category, according to identification of other Shyam Biswal, PhD is the director of the Center’s Essential Science Indicators, ISI cancer-preventing food DNA Micoarray Core Facility. The Core Facility Thompson. compounds and strategies. provides cutting-edge technologies for molecular biology research to Center members. This This research was the Biswal notes that more technology allows Center researchers to uncover first project to come out of recent studies show Nrf2 to the functions of genes and their interactions in genetic pathways by focusing research the Department’s new DNA be one of the most specifically on automated DNA microarraying and Microarray Core Facility, important transcription DNA sequencing hardware and software. which was started as a part factors related to of Johns Hopkins’ NIEHS environmental diseases such Center in Urban Environmental Health. The Core as COPD, asthma and cancer because it regulates Facility provides cutting-edge technologies for pathways that have the potential to annihilate molecular biology research, allowing researchers to inflammation and a broad spectrum of carcinogens. uncover the functions of genes and their interactions He said future studies will determine the response of in genetic pathways by focusing research specifically Nrf2 in several inflammatory diseases in the on environmental genomics. population and help design clinical trials based on activation of the Nrf2 pathway for several In the article, originally published in the journal environmental diseases. NIEHS Center Sponsored Seminars: Hottest Tickets in Town O On Wednesday, March 9, you didn’t have to go to Broadway for the hottest ticket around. It was standing room only at Dr. Donald Coffey’s lecture What We Know and What We Don’t Know About Cancer. Coffey is Professor of Urology, Oncology, Pharmacology and Molecular Sciences and Director of the Research Laboratories of the Urology Department at Johns Hopkins University. A recognized leader in prostate cancer research, Coffey is known for his engaging and animated presentations. His laboratory has made significant contributions through discoveries of how DNA of a cell is changed when cancer occurs and why that cell becomes resistant to treatment. Also discovered in his lab was the first nuclear scaffolding system, or nuclear matrix, which organizes DNA replication within the nucleus of a cell. Coffey’s lecture was part of an ongoing monthly seminar series co-sponsored by the NIEHS Center and Training Grant. NIEHS Center Sponsors Scientific Workshop M More than 100 scientists, faculty and students attended the 13th Annual Scientific Workshop, held Thursday, March 17. The 2005 workshop featured a presentation, Toxicoproteomies: Protein Targets of Reactive Electrophiles, by Daniel Liebler, PhD, Professor of Biochemistry and Pharmacology and Director of the Proteomics Laboratory Mass Spectrometry Research Center at Vanderbilt University School of Medicine. After the seminar, participants were invited to view posters presented by Training Program and Urban Environmental Health Center faculty and their preand postdoctoral students. This session provided an excellent format for interaction and discussion. Department Holds Biannual Research Retreat T The Department of Environmental Health Sciences held its biannual research retreat on January 13-14, 2005. The retreat took place at the Mount Washington Conference Center, nestled among the hills just beyond the city limits of Baltimore. The biannual retreat provides a forum for researchers to interact and discover common research interests. It also offers students an opportunity to learn about the research being conducted in each of the four divisions of the Department. The presentation theme for Thursday was lung-related research and Friday’s theme was metals. During lunch, students and postdocs presented their research and answered questions during an informal poster session. Friday’s social at the Mount Washington Tavern provide more opportunities for informal interactions between faculty and students. EHS Graduate Student Receives Prestigious Award E EHS graduate student Ms. Samar G. Khoury was chosen as one of the University’s three ARCS scholars for the 2005-2006 academic year. The award is to be used for education-related expenses such as tuition, books, supplies, travel to conferences, and research activities. Khoury will be invited to an ARCS Foundation awards ceremony in Washington, D.C. this fall. About our publication Connection is a free e-publication of the Department of Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public Health. The name Connection reflects the Department’s role, linking basic, population and clinical research in environmental health to public health intervention strategies. Editorial Staff Brian Fitzek, Research Associate Dan Gudgel, Publication Specialist Donna Mennitto, Contributing Writer Johns Hopkins Bloomberg School of Public Health Department of Environmental Health Sciences 615 N. Wolfe Street, Baltimore, MD 21205 tel: (443) 287-2905 fax: (410) 955-0617 email: [email protected] Departmental website: www.jhsph.edu/Dept/EHS Center in Urban Environmental Health website: www.jhsph.edu/Dept/EHS/Centers
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