David J. Lee, Ph.D.

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David J. Lee, Ph.D.

Associate Professor of Epidemiology & Public Health

Description of Research


Dr. Lee is a chronic disease epidemiologist with a long-standing interest in the prevalence of, and the morbidities associated with, sensory-related diseases and impairments. He also focuses on occupational health factors in cancer and associated risk factors. In collaboration with Dr. Fleming, Dr. Lee has published papers examining cancer risk in pesticide applicators and firefighters. Dr. Lee and colleagues also have examined smoking trends in 209 of the largest worker groups in the United States. In addition, this collaborative team has examined obesity trends in worker groups. Currently, research is being conducted that is examining trends in leisure time physical activity levels as well as the risk of lung cancer mortality in major worker groups. In this latter project, Dr. Lee and colleagues identified several occupational groups not previously known to have an increased risk of smoking-adjusted lung cancer mortality. These occupations included female managers, administrators, and financial records processors. Dr. Lee currently has an R03 application under review at the NCI to examine cancer risk factors in worker groups utilizing cancer supplement data from the 2005 National Health Interview Survey. Starting in 2000, Dr. Lee became increasingly involved in tobacco control research, serving as co-investigator of the Florida Youth Cohort Study. This study followed a sample of Florida adolescents to monitor changes in tobacco-related attitudes/beliefs and behaviors. Dr. Lee also was involved in the evaluation of the Minnesota tobacco control program, which was recently defunded. The effect of this defunding was detectable within six months. The program's termination was associated with increases in youth pro-tobacco attitudes and susceptibility to smoking initiation. Dr. Lee is currently principal investigator of a Flight Attendant Medical Institute "FAMRI"-funded grant to study the influence of secondhand smoke on the health of young adults. He also has an additional grant pending to examine worker health effects of occupational exposure to secondhand smoke. In early 2005, Dr. Lee was named research director of the Florida Cancer Data System "FCDS". As part of his duties, he assembled a multidisciplinary research team devoted to documenting tobacco-related cancer burden in Florida. He led efforts to compare trends in smoking-associated cancer incidence and mortality rates in Florida with national SEER data. Dr. Lee and his colleagues found that tobacco-associated cancer incidence is particularly high in white Floridians relative to whites residing in other states "e.g., lung cancer rates in Florida were 20 percent higher". Additional preliminary analysis indicates that tobacco-associated cancers tend to cluster in the northeast region of the state, with higher-than-expected mortality rates consistently seen in the panhandle region. Dr. Lee presently is leading this team in the writing of $1 million program project grant supported by the Florida-based James and Ester King Biomedical Research Program to complete these analyses. If funded, this proposal will lead to the development of an NCI program project designed to reduce tobacco use "primary prevention", increase early detection "secondary prevention", and provide better treatment "tertiary prevention" for Floridians suffering from tobacco-associated cancers.

Highlights / Discoveries

  • Reported that smoking rates vary widely by occupational group ranging from four percent in physicians to 58 percent in roofers. Significant reductions in smoking rates from 1987-1994 occurred exclusively in white-collar professions, while blue-collar workers continue to smoke in large numbers.
  • Found that female firefighters working in Florida had significantly increased incidence of all cancers, thyroid cancers, and Hodgkin's disease. In a national study found several occupational groups at increased risk of lung cancer after adjustment for smoking status heating and air refrigeration mechanics, other mechanics, financial records processors and materials handlers.
  • Reported that health care providers routinely fail to advise their patients to quit smoking, including workers employed in jobs with increased risk of occupational respiratory exposures
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  • Found that lung cancer rates in white Floridians were elevated through the 1990s relative to whites residing in other states with an opposite pattern noted for blacks
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    Selected Cancer-Related Publications

    Lam BL, Lee DJ, Zheng DD, Davila EP, Christ SL, Arheart KL. Disparity in prevalence of self-reported visual impairment in older adults among u.s. Race-ethnic subgroups. Ophthalmic Epidemiol 16:144-50, 2009. Read the publication »

    Lee DJ, Lam BL, Arora S, Arheart KL, McCollister KE, Zheng DD, Christ SL, Davila EP. Reported Eye Care Utilization and Health Insurance Status Among US Adults. Arch Ophthalmol 127:303-10, 2009. Read the publication »

    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 the publication »

    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 the publication »

    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 the publication »

    Brookfield KF, Cheung MC, Gomez C, Yang R, Nieder AM, Lee DJ, Koniaris LG. Survival disparities among African American women with invasive bladder cancer in Florida. Cancer 115:4196-209,2009. Read the publication »

    McCollister KE, Arheart KL, Chung-Bridges K, Christ S, Clark J 3rd, Lewis JE, Davila EP, Rouhani P, Fleming LE. Reported skin cancer screening of US adult workers. J Am Acad Dermatol 59:55-63, 2008. Read the publication »

    Arheart KL, Lee DJ, Dietz NA, Wilkinson JD, Clark JD 3rd, Leblanc WG, Serdar B, Fleming LE. Declining Trends in Serum Cotinine Levels in US Worker Groups: the Power of Policy. J Occup Environ Med 50:57-63, 2008. Read the publication »

    Nieder AM, Mackinnon JA, Huang Y, Fleming LE, Koniaris LG, Lee DJ. Florida bladder cancer trends 1981 to 2004: minimal progress in decreasing advanced disease. J Urol 179:491-5; discussion 495, 2008. Read the publication »

    Arheart KL, Lee DJ, Fleming LE, Leblanc WG, Dietz NA, McCollister KE, Wilkinson JD, Lewis JE, Clark JD 3rd, Davila EP, Bandiera FC, Erard MJ. Accuracy of Self-Reported Smoking and Secondhand Smoke Exposure in the US Workforce: The National Health and Nutrition Examination Surveys. J Occup Environ Med 50:1414-1420, 2008. Read the publication »

    Nieder AM, Lee DJ. Re: The causal role of cigarette smoking in bladder cancer initiation and progression, and the role of urologists in smoking cessation: S. A. Strope and J. E. Montie J Urol 2008; 180: 31-37. J Urol 180:2713, 2008. Read the publication »

    Fleming LE, Levis S, LeBlanc WG, Dietz NA, Arheart KL, Wilkinson JD, Clark J, Serdar B, Davila EP, Lee DJ. Earlier age at menopause,work,and tobacco smoke exposure. Menopause 15:1103-8,2008. Read the publication »

    Lee DJ, Voti L, MacKinnon J, Koniaris LG, Fleming LE, Huang Y, Wohler B, Franceschi D, Dietz NA, Sherman R, Soler-Vilá H. Gender- and race-specific comparison of tobacco-associated cancer incidence trends in Florida with SEER regional cancer incidence data. Cancer Causes Control 19:711-23, 2008. Read the publication »

    Lee DJ, Dietz NA, Arheart KL, Wilkinson JD, Clark JD 3rd, Caban-Martinez AJ. Respiratory effects of secondhand smoke exposure among young adults residing in a "clean" indoor air state. J Community Health 33:117-25, 2008. Read the publication »

    Clark JD 3rd, Wilkinson JD, LeBlanc WG, Dietz NA, Arheart KL, Fleming LE, Lee DJ. Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers. Am J Ind Med 51:626-32, 2008. Read the publication »

    Chung-Bridges K, Muntaner C, Fleming LE, Lee DJ, Arheart KL, LeBlanc WG, Christ SL, McCollister KE, Caban AJ, Davila EP. Occupational segregation as a determinant of US worker health. Am J Ind Med 51:555-67, 2008. Read the publication »

    Mackinnon JA,Duncan RC,Huang Y,Lee DJ,Fleming LE,Voti L,Rudolph M,Wilkinson JD. Detecting an Association between Socioeconomic Status and Late Stage Breast Cancer Using Spatial Analysis and Area-Based Measures. Cancer Epidemiol Biomarkers Prev 16:756-62,2007. Read the publication »

    Perez EA,Koniaris LG,Snell SE,Gutierrez JC,Sumner WE 3rd,Lee DJ,Hodgson NC,Livingstone AS,Franceschi D. 7201 carcinoids: increasing incidence overall and disproportionate mortality in the elderly. World J Surg 31:1022-30,2007. Read the publication »

    Perez EA, Gutierrez JC, Jin X, Lee DJ, Rocha Lima C, Livingstone AS, Franceschi D, Koniaris LG. Surgical Outcomes of Gastrointestinal Sarcoma Including Gastrointestinal Stromal Tumors: A Population-based Examination. J Gastrointest Surg 11:114-25, 2007. Read the publication »

    Fleming LE, Lee DJ, Caban-Martinez AJ, LeBlanc WG, Bridges Chung K, Christ SL, Arheart KL, McCollister K, Pitman T. The Health Behaviors of the Older US Worker: The National Health Interview Survey American Journal of Industrial Medicine. 50:427-437,2007. Read the publication »

    Lee DJ, Fleming LE, Arheart KL, Leblanc WG, Caban AJ, Chung-Bridges K, Christ SL, McCollister KE, Pitman T. Smoking Rate Trends in U.S. Occupational Groups: The 1987 to 2004 National Health Interview Survey. J Occup Environ Med 49:75-81, 2007. Read the publication »

    Lee DJ, Fleming LE, McCollister KE, Caban AJ, Arheart KL, LeBlanc WG, Chung-Bridges K, Christ SL, Dietz N, Clark JD 3rd. Healthcare provider smoking cessation advice among US worker groups. Tob Control 16:325-8, 2007. Read the publication »

    Wilkinson JD, Lee DJ, Arheart KL. Secondhand smoke exposure and C-reactive protein levels in youth. Nicotine Tob Res 9:305-7, 2007. Read the publication »

    Programs

    See the full description of the Multidisciplinary Research Program(s): Cancer Epidemiology & Prevention Program