YaleYale PublicPublic HealthHealth FALL 2013 FALL 2009 Brain tumors, genomics and the quest for answers How healthy are our homes? Yale school of public health • Flame retardants • A holistic approach • Food safety • Fighting Lyme disease Tracking 100,000 children • The end of an era Global health | Lyme cartography Assam odyssey | Chronicling abuse YaleYale school school of of public public health health iv yale public health Yale Public Health FALL 2013 2 Dean’s Message 3 Editor’s Note 4 Advances 7 Perspective 8 Health threats in the household 10 Toxic protectors Flame retardants are meant to keep people safe, but the powerful chemicals may be causing cancer and other diseases. 16 Creating healthier homes A researcher with a background in lead poisoning takes a holistic approach to safer, healthier living environments. 22 Food sleuths YSPH programs help safeguard food supply by investigating breaking cases of foodborne illness throughout Connecticut. 28 Backyard science Researchers are looking at whether bait boxes can break the transmission cycle of Lyme and other tick-borne diseases. 32 A conversation with Gary Ginsberg 34 Students 38 Alumni 43 YSPH Notes 65 In Memoriam 68 Yesterday 69 Today Yale school of public healthfall 2012 v Dean’s Message Better health starts at home It is no secret that our environment Years ago, substances such as lead affects our health. However, when were commonly used throughout Our homes are the we think of environment, we usually houses with little awareness of their consider the air we breathe or the serious side effects. We now know places where most water we drink. Most of us do not give the harm that exposure to even small much thought to the ways in which amounts of lead can cause, and the of us feel safest and one of the most important parts of our government has rightfully taken deci- environment—our homes—shape our sive action to restrict its use. Even with health. this intervention, lead exposure still most comfortable. In this, our 10th issue of Yale Public poses a significant health threat. Health, we explore the pioneering Dr. Adrienne S. Ettinger, who But our living research conducted by Yale School of joined our faculty a few years ago, Public Health scientists to make the brings with her a wealth of experience environments can places where we live healthier and safer. and expertise on this important topic These researchers are seeking to answer and shares some of her insights with also pose very essential questions—whether and us in this issue. In addition to lead, she how chemicals, additives, pathogens, is looking at homes and health more disease vectors and other sources affect holistically, collaborating with col- serious threats to our health. leagues at Yale and elsewhere on what One of our faculty, Dr. Yawei constitutes a healthy home and how our well-being. Zhang, is seeking to understand we can start achieving this ideal. whether flame retardants, substances Health threats also come from the that are liberally applied to many of food we eat and from the insects and the products in our homes, are related wild animals that inhabit our lawns to a sharp increase in thyroid cancer, and recreation areas. The Connecticut particularly among women, and are Emerging Infections Program at YSPH causing developmental problems in is actively working to minimize the children. Flame retardants, of course, threat from these sources and others. are meant to protect us from fire, and They monitor, record and investigate thus they serve a vital purpose and food-related diseases and work with undoubtedly have saved lives. But health officials at the state and federal repeated, close exposure to the power- levels so that contaminated foods are ful chemicals used for this purpose removed as swiftly as possible. Mean- may have unintended, harmful conse- while, they are also researching an quences that we are only now starting approach to fighting Lyme and other to recognize. Two of her studies now tick-related diseases. under way could provide crucial Better health is a goal that we all answers about such potential risks. share, and our researchers are mak- Our homes are the places where ing important contributions so that most of us feel safest and most com- we may all live happier and healthier fortable. But our living environments lives—in our homes. can also pose serious threats to our Paul D. Cleary, Ph.D. well-being. It is essential that houses Dean, Yale School of Public Health of the future be constructed with human health as a central design feature. 2 yale public health YaleYale PublicPublic HealthHealth SPRING 2013 Editor’s Note FALL 2009 Brain tumors, genomics YSPH research helps change and the quest for answers state law Yale Public Health For minors who engage in indoor Yale school of public health The Journal of the Yale School of Public Health Fall 2013, Vol. 5, No. 2 tanning, the habit will be a little Toward a healthierTracking 100,000 future children for women Global health | Lyme cartography more diffi cult in Connecticut start- Indoor tanning Assam| Circadian odyssey clocks | Chronicling | Preventing abuse violence A new tick disease | Rating health Dean ing this fall. Paul D. Cleary, Ph.D. YaleYale school school of of public public health health The Anna M.R. Lauder Professor of Public Health Gov. Dannel P. Malloy this past summer signed into law a measure Managing Editor that makes it illegal for people under countering some of the misinfor- Michael A. Greenwood 17 years old to use indoor tanning mation put forth by the industry,” Web Coordinator facilities (see picture of bill signing said Susan T. Mayne, the C.-E. A. Denise L. Meyer on page 57). Winslow Professor of Epidemiol- The new law was prompted in ogy and a cancer epidemiologist at Copy Editor Anne Sommer part by scientifi c research, pub- the Yale School of Public Health. lished in 2012 and led by the Yale Mayne was the senior epidemiolo- Design School of Public Health, that found gist on the study and testifi ed on the AH Design, Angie Hurlbut a strong link between even mod- bill’s behalf in March during a public NYM Design, Nilou Moochhala erate amounts of indoor tanning hearing in Hartford. She collabo- Address correspondence to and the risk of basal cell carcinoma rated on the study with a number of Managing Editor, Yale Public Health (BCC), a form of skin cancer. The colleagues from the Yale schools of 47 College Street, Suite 104 P.O. Box 208034 fi nding added to the evidence that public health and medicine. New Haven, CT 06520-8034 the powerful ultraviolet rays used The Public Health Committee of Phone: 203-737-5151 during indoor tanning can trigger the Connecticut General Assembly Fax: 203-785-7296 E-mail: [email protected] melanoma, a potentially deadly form noted that the Yale study was in- Web: publichealth.yale.edu of skin cancer. strumental in passing the legislation The Yale research, featured in this year (similar bills had failed in Yale Public Health is published twice a year and is the Spring 2013 issue of Yale Public previous years). distributed to alumni, faculty, students and friends of the Yale School of Public Health. Health, surveyed some 800 people The governor, meanwhile, under age 40 in Connecticut (half congratulated lawmakers, scientists Acronyms used in Yale Public Health include YSPH with skin cancer, half without) and and advocates for their combined for Yale School of Public Health and LEPH for Laboratory of Epidemiology and Public Health found that indoor tanning was as- work on legislation that will help to (the school’s main building). sociated with a 69 percent increased protect Connecticut’s youth. risk of BCC. More than 80 percent Dean Paul D. Cleary also com- Cover art by Michael Woloschinow of the females under age 40 who mended the new public health Printer had skin cancer had tanned indoors, legislation. Pyne-Davidson Co. mainly in commercial tanning facili- “I was absolutely delighted when Printed on recycled paper ties. Furthermore, the study con- I heard that Governor Malloy had with soy-based inks cluded that nearly half of early-onset signed the bill banning indoor tan- BCCs in women could be avoided if ning for minors,” he said. “This is a they never tanned indoors. perfect example of how collaborative Follow the Yale School of Public Health on Facebook, Twitter, LinkedIn and Pinterest. “Passage of this legislation ac- research and dissemination efforts complishes two things. It protects can translate scientifi c fi ndings into Connecticut minors from early-life policy that will improve the health of exposures that are now recognized our communities.” A digital archive of Yale Public Health is available at as cancer-causing. It also sends a Michael Greenwood publichealth.yale.edu/news/magazine/index.aspx. strong message to adults that indoor Managing Editor tanning is a recognized health risk, fall 2013 3 Advances Social media as a platform Over a third of the sites advocated for ageism banning older persons from public ac- tivities. The activities mentioned most At the same time that Facebook is were shopping and driving. Addition- revolutionizing the way that people ally, on one-quarter of the sites, the communicate, recent research shows elderly were portrayed as infantile. In affl icts thousands of people in rural that it also provides a platform for these cases, they were described with regions of sub-Saharan Africa, under- the enduring problem of negative age such phrases as “a smaller, younger goes a complex life cycle between stereotypes. child.” the mammalian host and the blood- Investigators led by Becca Levy, The study is believed to be the feeding tsetse fl y.