Brian

Schwartz

, MD, MS

A large part of my research applies the methods of occupational, environmental, and molecular epidemiology to studying the health effects of chemicals. Health effects of interest include those in the central nervous (e.g., cognitive function, brain structure), peripheral nervous, cardiovascular, and renal systems. My research has focused on the health effects of metals (e.g., organic lead, inorganic lead, mercury, cadmium) and various organic compounds (e.g., polychlorinated biphenyls, hydrocarbon solvents).  We are particularly interested in the importance of recent vs. lifetime cumulative dose, the timing of the dose during the lifespan and its relation to health effects, how these each contribute to acute, reversible health effects and chronic, likely irreversible health effects, and how chemicals interact with aging to influence health across the lifespan. The studies are also evaluating whether genetic polymorphisms interact with chemical exposures to modify disease risk, an evaluation of gene-environment interaction. We have used several biologic markers of chemical dose in studying health effects, including some health outcomes never before studied in relation to chemicals.  We have recently found that cumulative lead dose, measuring lead concentration in bone with X-ray fluorescence, is associated with persistent structural lesions in the brain (i.e., smaller volumes of brain structures and increased prevalence and severity of white matter lesions), and these, in turn, are associated with progressive declines in cognitive function as people age. 
I have become increasingly interested in the issue of global environmental sustainability, and how land use and energy use are contributing to global climate change, ecosystem degradation, and biodiversity and species losses, and ultimately, posing important risks to individual and population health.  Much of this research is part of my work as Director of the Environmental Health Institute at the Geisinger Center for Health Research in Danville, PA. There we have ongoing or developing studies of the built environment and obesity, with particular emphasis on the land use, local food, local physical activity, and social environments; the public health impacts of Marcellus shale development in Pennsylvania; the community health effects of animal feeding operations, including the risk of methicillin-resistant Staphylococcus aureus (MRSA); the built environment, abandoned coal mine lands, and diabetes mellitus progression; the contribution of abandoned mine lands to community health and contextual effects; and evaluating the public health risks of energy scarcity and changing energy choices.  As the co-director of the Program on Global Sustainability and Health, we are developing courses and research related to these areas.