Lora Fleming, M.D., Ph.D.
Professor of Epidemiology & Public Health
Description of Research
As the only board certified Occupational and Environmental Medicine Physician and Epidemiologist in South Florida, Dr. Fleming serves in a unique role at the University of Miami. Her areas of research and teaching are Occupational and Environmental Medicine, and Epidemiology. As the Co-Director of the National Science Foundation (NSF)- National Institute of Environmental Health Sciences (NIEHS) University of Miami Oceans and Human Health Center (www.rsmas.miami.edu/groups/ohh) and the Associate Director of the Florida International University (FIU)-University of Miami NIEHS ARCH Program ( www.arch.fiu.edu ), she works in the areas of Marine and Freshwater Toxins, Recreational Microbes, Environmental Human Health, and Epidemiologic issues. Working with various Center colleagues and others, she has created educational materials concerning the human health effects of marine and freshwater natural toxins, and performed research in Ciguatera Fish Poisoning, Florida Red Tides (Brevetoxins) and cyanobacterial toxins. Currently, she is involved in a NIEHS-funded study of the human health effects of aerosolized red tide toxins (www.mote.org/niehsredtidestudy) and in a CDC, FL DOH and OHH Center funded study of the possible human health effects of microbial pollution in recreational beach waters. With a group of interdisciplinary colleagues, she is exploring the health disparities, morbidity and mortality of U.S. workers in the National Health Interview Survey funded by the National Institute of Occupational Safety and Health (NIOSH) ( www.umiamiorg.com ), as well as issues of second hand smoke on worker health and the prevention of tobacco-related diseases. As Medical Director of the Florida Cancer Data System (www.fcds.med.miami.edu), Florida’s incident cancer registry, she works with researchers and students to promote work in cancer epidemiology and prevention, and health disparities in Florida. She teaches physicians and residents, and PhD and Masters of Public Health, medical, law, architecture, and undergraduate students in environmental and occupational health and epidemiology. She also acts as a Consultant in Occupational and Environmental Medicine and Epidemiology both locally and internationally, and serves on a number of University, State and National Taskforces and Committees.Highlights
- Examination of the cancer risks associated with firefighting in Florida
With NIOSH funding, the cancer risks associated with firefighting in Florida are being examined. A retrospective cohort study, the largest ever conducted in firefighters, was conducted in Florida in 1972 and 1999. A total of 1,032 cases of cancer among Florida firefighters (970 male and 52 female) were identified by linkage with the Florida Cancer Data System. The overall risk of cancer among male firefighters was significantly lower relative to that of the general Florida population. Significantly increased cause-specific cancer incidence was observed among male firefighters for bladder, testes, and thyroid cancers. Female firefighters had significantly higher (increased) rates of thyroid cancers as well as Hodgkin’s disease. - Arsenic in CCA Treated Wood Playgrounds
The carcinogen metal, Arsenic, from chromated copper arsenate (CCA)-treated wood, which is widely used in playgrounds and other outdoor equipment, can persist as surface residues on wood. This raises concerns about possible health risks associated with children playing on CCA-treated playgrounds. With pilot funds from the NIEHS, Dr Fleming and colleagues evaluated the environmental exposure of children playing on CCA and non-CCA treated wood playgrounds. This preliminary pilot study of CCA-treated wood playgrounds observed dislodgeable arsenic on 11 children’s hands after brief periods of play exposure. Future efforts should increase the number of children and the play exposure periods and incorporate specification in order to discriminate between various sources of arsenic. - Local and Regional Breast Cancer Treatment Differences
Florida Cancer Data System and Florida Agency for Health Care Administration data were used to evaluate risk factors for receiving appropriate treatment for local and regional breast cancer among Florida women. Factors such as age, race, ethnicity, type of hospital, and distance to radiation facility were identified.
Selected Cancer-Related Publications
- Brookfield KF, Cheung MC, Lucci J 3rd, Fleming LE, Koniaris LG. Disparities in survival among women with invasive cervical cancer : a problem of access to care. Cancer 115:166-78, 2009. Read more »
- Pinheiro PS, Sherman RL, Trapido EJ, Fleming LE, Huang Y, Gomez-Marin O, Lee D. Cancer incidence in first generation U.S. Hispanics: Cubans, Mexicans, Puerto Ricans, and new Latinos. Cancer Epidemiol Biomarkers Prev 18:2162-9, 2009. Read more »
- Vidal L, LeBlanc WG, McCollister KE, Arheart KL, Chung-Bridges K, Christ S, Caban-Martinez AJ, Lewis JE, Lee DJ, Clark J 3rd, Davila EP, Fleming LE. Cancer screening in US workers. Am J Public Health 99:59-65, 2009. Read more »
- Nieder AM, MacKinnon JA, Fleming LE, Kearney G, Hu JJ, Sherman RL, Huang Y, Lee DJ. Bladder cancer clusters in Florida: identifying populations at risk. J Urol 182:46-50; discussion 51, 2009. Read more »
Programs
Collaborating in the Multidisciplinary Research Program(s):