Education and Outreach

COEP Summary

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Objectives: The COEP Objectives mirror those of the University of Miami NIEHS Marine and Fresh Water Biomedical Sciences Center:

To foster collaborative investigations in the two Center target research areas:
Marine & Fresh Water Toxins and Human Disease
Marine & Fresh Water Models of Human Health
To educate and serve as a resource concerning the human health and environmental impacts of the Marine and Fresh Water Toxins and the importance of Marine and Fresh Water Models for our target groups: health care providers and patients, (as well as the scientific community, media and the general public).

The COEP activities of the NIEHS Center have expanded in several directions over the past 14 years, thanks to the scientific and monetary support of the NIEHS Center, as well as the NSF NIEHS Oceans and Human Health Center, the Rosenstiel School of Marine and Atmospheric Sciences, the University of Miami School of Medicine, the University of Miami School of Arts and Sciences, Florida International University (FIU), the FIU NIEHS-funded ARCH Program, the Florida Poison Information Center, the Florida Dept of Health, the Florida Harmful Algal Bloom Taskforce, Miami Dade County Dept or Health, Miami Dade County Public Schools, and various Florida healthcare providers and public health practitioners. The major areas of development of COEP have been:

Harmful Algal Bloom Surveillance, Education and Outreach targeted at patients and Health Care Providers
K-12 Education: the NIEHS AMBIENT Project
Environmental Ethics
Oceans & Human Health Town/School Meetings

In addition, the COEP at the NIEHS Center has been the source of significant new Research into Oceans and Human Health and other environmental health issues.

1) Local and National Collaborations & Educational Activities: The NIEHS Center Website (http://www.rsmas.miami.edu/groups/niehs/ ) provides one of the few scientifically valid websites focused on the human health effects of the Harmful Algal Blooms (HABs). In addition to administrative and scientific information concerning the NIEHS Center, there are patient and healthcare provider targeted downloadable information concerning the diagnosis, treatment, prognosis and epidemiology of the marine and fresh water toxins and human health. In addition, the TOXMASTER email site linked to the NIEHS Center Website has provided a venue for patients, healthcare providers, as well as other scientists, reporters, lawyers, and the general public, to ask questions concerning possible human health effects of the harmful algal blooms. The Center Website receives multiple hits and queries/day from Florida, the US, the Caribbean, and internationally as well as regularly providing downloadable and mailable packets of educational materials (see below Materials and/or Publications).

In addition to multiple resources listed below, a VideoConference entitled “Harmful Algal Blooms in Florida” (June 1999) was developed by Center Investigators with support from the CDC and Florida Dept of Health, and broadcast to Florida physicians and health department personnel. A video, annotated slides and educational materials were developed for distribution both locally and regionally. Other materials are available, such as a CD Version of an Environmental Health Touch Screen used at the 1998 Lisbon World Expo. Finally, the AMBIENT Program has created environmental health curriculum targeted at high school teachers and students (see below) at www.rsmas.miami.edu/groups/niehs/ambient/.

2) Marine & Fresh Water Toxin Hotlines (888-232-8635): The NIEHS Center created and contributes to the Marine and Fresh Water Toxin Hotline of the South Florida Poison Information Center. The South Florida Poison Information Center receives calls on Marine and Fresh Water illnesses from all over Florida, the US and internationally. It is a toll free 24 hour 365 day/year multi-lingual (English, Spanish and Haitian Creole with availability of 125 other translated languages) hotline. It provides diagnostic, treatment and educational information, and will report officially cases of reportable diseases (such as Ciguatera, PSP, Scombroid, tetrodotoxin poisoning, NSP, and aerosolized Florida Red Tide) to the Florida Dept of Health. Additional informational follow-up is performed by referral to NIEHS Center personnel. In addition, this Hotline is known as the Marine and Fresh Water Toxin Disease Resource for the national and international Poison Control Network. This Hotline serves not only as an informational resource, but also to begin the process of case surveillance for the highly under-reported Marine and Fresh Water Toxin Diseases. Since many of the calls concern Florida Red Tides, specific information in Spanish and English has been added in a Menu Format on this issue; there are plans to expand this service to include shellfish-borne diseases, ciguatera and the cyanobacteria, as well as evaluate this service. A packet of general information on the Marine & Fresh Water Toxin Diseases is sent to callers at their request; these readings are also posted on the Center Web site. Referrals are made for clinical treatment and laboratory testing, as well as surveillance recommendations and case reporting to the Florida Dept of Health and CDC.

3) NIEHS MFBSC/NSF/FIU Town Meeting & School Meeting on Oceans & Human Health, Risks and Remedies from the Sea (http://www.rsmas.miami.edu/groups/niehs/townmeeting2003) was held on February 27 and 28, 2003 at the University of Miami Rosenstiel School of Marine and Atmospheric Sciences and at the Miami Dade County Public School MAST Academy to bring together members of NIEHS-NSF community, the University of Miami, the FIU ARCH Program, scientists, community leaders, politicians, public school students and teachers, the press and the general public to discuss this new NIEHS-NSF research agenda. NIEHS Director Dr. Kenneth Olden and others started the NIEHS Town Meeting with introductory comments. A “Science and Community” panel of leading scientists presented a range of scientific perspectives on the connections between oceans and health. Following the panel, a moderated open-mike session established a dialogue between scientists, community leaders, and the general public

Oceans and Human Health Challenge “Celebrity” Scientists
Dan Baden, PhD	(University of North Carolina - Wilmington)
Lora E Fleming MD PhD	(UM NIEHS Center)
Roberta Johnson, PhD	(National Center for Atmospheric Research)
Gus Loret de Mola, EdD	(Miami-Dade County Public Schools)
Ken Olden, PhD	(NIEHS)
Shirley Pomponi, PhD	(Harbor Branch Oceanographic Institute, FL)
Ellen Prager, PhD	(University of Miami)
Helena Solo Gabriele, PhD	(Univ of Miami)
Fred Tyson, PhD	(NIEHS)
Pat Walsh PhD	(UM NIEHS Center)

For the following day, the COEP organized a one-of-a-kind school meeting and event –the “Oceans and Human Health Challenge” – at the Miami-Dade County Public Schools Maritime and Science Technology High School (MAST Academy). This unique experience provided an opportunity for students to interact with senior scientists and government officials in an entertaining and educational format of an Oceans and Human Health Game Show. Hosted by Mr Jeff Burnside of NBC6, the MAST Academy award winning Ocean Bowl Teams asked Oceans and Human Health questions of a Panel of distinguished scientists from government, academy and industry. Afterwards, students were able to address specific questions to the Scientists about scientific issues and careers.

This Town Meeting has lead to some interesting community collaborations between the NIEHS Center and Audubon of Florida. With supplemental funding from NIEHS, an Audubon AMBIENT Module was created on Environmental Justice and targeted at high school teachers and students (www.rsmas.miami.edu/groups/niehs/ambient/).

4) NIEHS k-12 funded AMBIENT Project (Atmospheric and Marine-Based Interdisciplinary Environmental health science Training) (http://www.rsmas.miami.edu/groups/niehs/ambient/). Science literacy throughout the US has been in steady decline for a number of years, especially among minority students. Miami-Dade County is home to a large and diverse population—52% Hispanic, 34% African American, 13% White, and 1% American Indian/Asian/other. As does any community of this complexity, Miami-Dade County struggles with urban environmental health issues and disparities in health and education among ethnic groups.

The UM COEP has recognized an important need within the public schools for involving students with research scientists and members of the community in a systemic, interdisciplinary approach to learning about local environmental health science issues. Through the seven-year AMBIENT Project (Atmospheric and Marine-Based Interdisciplinary ENvironmental Health Science Training), the UM COEP is developing and implementing such an approach. AMBIENT is funded through an NIEHS EHSIC (Environmental Health Science as an Integrative Context) grant.

The AMBIENT project supports curriculum development and teaching training, aiming to implement a culturally-sensitive curriculum that will motivate, engage, and prepare Miami’s high school students to improve overall academic performance, complete their high school education, and pursue careers in natural science. The resulting AMBIENT curriculum is interdisciplinary and problem-based, focused around the four themes of air, water, soil, and food.

UM’s AMBIENT Group
Principal Investigator:	Dr. Patrick Walsh, Center Director
Study Coordinator:	Dr. Lisa Pitman, Miami Dade Public Schools Educational Specialist
Environmental Health Scientist:	Dr. Lora Fleming, COEP Director
Ethics Investigator:	Dr. Ken Goodman
External Evaluator:	Dr Hilarie Davis
Curriculum:	Wendy Stephan MPH

During the summers, AMBIENT brings teachers together to learn about environmental and ethical issues through a hands-on workshop. Instructors, including research scientists from UM, Florida International University, and the Miami-Dade County Department of Health, assemble and present best practices from existing environmental curriculum materials. Teachers learn and share team-teaching techniques and strategies for maximizing effectiveness with large classes (which are often over 35 students). An outside Evaluator provides on-going formative and summative assessment of the project.

The AMBIENT group hosted the K-12 Annual Grantees Meeting in Miami in February 2003. In collaboration with the Rutgers NJDMJ NIEHS Center, the TOXRAP curriculum was disseminated through the AMBIENT group. AMBIENT was selected to present curriculum at EHSTEP at Rutgers NJDMJ NIEHS Center. The AMBIENT Group has also presented at the National Science Teachers Association (NSTA), Florida and Georgia Science Teachers Associations, as well as other venues; the AMBIENT Group will be presenting at the Society of Toxicology in conjunction with NIEHS and other NIEHS funded K-12 Programs. Currently, as an outgrowth of the NIEHS Town Meeting, the AMBIENT group has worked with Audubon of Florida to design an Audubon AMBIENT Module on Environmental Justice targeted at inner city high school students; this module was given in the summer of 2004 with ongoing follow up currently. AMBIENT also participates annually in the Regional ENVIROTHON Program by producing a set of questions and hosting a booth for high school students in the South Florida Region (with downloadable materials at the AMBIENT Website).

Dr Lisa Pitman and Ms Wendy Stephan are currently participating in the NIEHS pilot project to create a monthly student edition of the Environmental Health Perspective magazine and three accompanying lessons per month (http://ehp.niehs.nih.gov/science-ed/).. The magazine and lessons target high school level science classes and meet a variety of National Science Teaching & Content Standards. This Project has been refunded for an additional year and the Investigators are seeking additional funding to become a long-term project. Another important component of this project is to connect COEPs for a unified, national project that utilizes individual COEP resources.

Dr Pitman has also has created an opportunity for Miami Dade County Public School teachers to participate with researchers on the Royal Caribbean Cruise Line Explorer of the Seas. Teachers sail on Explorer of the Seas as resident scientists for the week. They perform research activities along with university scientists in the oceanographic and atmospheric laboratories onboard the ship. Teachers produce a curriculum module with separate classroom lessons developed from their research onboard. Ongoing real-time data is provided for use in classrooms year-round. Teachers present their experiences and resulting lessons at regional or national educator conferences or meetings after their cruise.

5) The NIEHS funded Advanced Research Cooperation in Environmental Health Sciences (ARCH) Program (http://www.rsmas.miami.edu/groups/niehs/arch/) of Florida International University (FIU) and the University of Miami (UM) is targeted at Faculty and Research Infrastructure Development for minority researchers and students. Under the Leadership of Dr Kelly Rein (FIU ARCH Principal Investigator), the NIEHS Center has integrated its Center Listserv and Research Seminars, as well as Pilot Project Funding, with the ARCH Program. ARCH Investigators have participated in K-12 AMBIENT environmental health science curriculum development as well as other COEP events.

6) Environmental Ethics is a focus of the NIEHS Center and the COEP Program. Dr Ken Goodman, Director of the University of Miami Bioethics Program, is a NIEHS Center Investigator. Dr Goodman developed an NIH funded Extreme Ethics Course which explores ethical issues in genetics (including toxicogenetics and transgenics) and environmental and occupational health. He developed an Environmental Ethics Forum with Miami Dade County Public Schools and Miami Dade County Commissioners, in which the AMBIENT Group has participated. He is the Ethics Consultant on the NIEHS K-12 AMBIENT Project, and has designed an AMBIENT Ethics Module in collaboration with Dr Hilarie Davis, the AMBIENT Evaluator. In 2003, Dr Lynne Fieber, Center Investigator, and Dr Ruben Rubinsky, NIEHS Center Post Doc, developed and taught a course on Environmental Ethics to undergraduate and graduate students at the University of Miami; using environmental case studies, Drs Fieber and Rubinsky presented information and differing ethical points of view as scientist and ethicist.

7) COEP generated Research:The COEP has completed several Pilot Studies which have responded to community concerns.

The first Pilot Study was with environmental engineer, Dr Helena Solo Gabriele (Dept of Engineering and Adjunct at RSMAS, University of Miami) and Dr Lora Fleming entitled “A Pilot Study Evaluation of Microbial Recreational Water Indicators in the Subtropical Marine Environment” in collaboration with the Miami Dade County Health Dept and NIH funded Minority Student Program. The study was in response to community concerns about recreational marine water quality; it encompassed environmental survey and sampling as well as interviewing bathers (http://www.eng.miami.edu/~hmsolo/Hobe/HCframes.html). This study has been expanded as one of the 3 Research Projects of the NSF NIEHS Oceans and Human Health Center.
The second Pilot Study entitled “Recreational exposure to freshwater cyanobacteria – an international prospective epidemiology study” with FIU ARCH Investigator Dr Miro Gantar, Dr Lora Fleming, CyanoLab Mr John Burns and the University of Queensland Mr Ian Stewart, focused on recreational exposure to blue green algae in Florida and Australian fresh water. This study was in response to community concern about recreational freshwater quality; it involved environmental sampling as well as interviewing bathers (http://www.rsmas.miami.edu/groups/niehs/arch/projects.htm). CDC and Florida Dept of Health collaborators are planning to repeat this study with an emphasis on exposure monitoring and expanded health effects surveillance in cyanobacterial contaminated lakes in Florida and elsewhere.
In the third Pilot Study entitled “Pilot Study of Children’s Exposure to CCA-Treated Wood from Playground Equipment”, Dr Helena Solo Gabriele (Dept of Engineering and RSMAS, University of Miami) and Dr Fleming in collaboration with Drs Stuart Shalat and Brian Buckley of EOHSI NIEHS Center at Rutgers Medical College of New Jersey evaluated the possible exposure to arsenic in toddlers from playing on CCA treated wood equipment.

Prior to the development of the University of Miami NIEHS Center, there had been very little research, particularly from an epidemiologic and clinical perspective, of the human health effects of the Harmful Algal Blooms. As a result, the activities of NIEHS COEP have been a source of considerable new research in this area, including:

Study of Emergency Room Respiratory Diagnosis Admissions during Florida Red Tides
A Pilot Study of Poison Information Calls and Aerosolized Red Tide
The Pilot Study of Aerosolized Red Tides and their Effects on Human Health
Neuropsychological Effects of Ciguatera Fish Poisoning
The Pilot Study of Occupational Harmful Algal Blooms
Ciguatera Fish Poisoning Reporting by physicians in an endemic area
Reported Ciguatera Cases in South Florida using Establishment of a Marine Seafood Toxin Disease Hotline
Outreach and Education through Establishment of a Marine Toxin Disease Hotline
GIS and the Epidemiology of the Marine Toxin Diseases (NIEHS Shannon Award)

Blue Green Algal Toxins, Surface Drinking Water, and Hepatocellular Carcinoma
Blue Green Algal Toxins, Surface Drinking Water, and Colorectal Carcinoma
Geographic Information Systems (GIS) and Endemic Ciguatera Fish Poisoning

Members:
Lora E Fleming MD PhD MPH, Professor, Outreach Director*
Lisa Pitman EdD (Miami Dade County Public Educational Specialist) Study Coordinator of the AMBIENT Program and COEP Coordinator**
Pat Walsh PhD, Professor, NIEHS Center Director*
Gayl van de Bogart (NIEHS Center Administrator)
Richard Weisman PharmD (Director South Florida Poison Control & Associate Professor, Dept of Pediatrics) **
Ken Goodman PhD, University of Miami School of Medicine*
Donna Blythe MD, Adjunct Assistant Professor, Dept of Medicine**
Wendy Stephan MPH**
Helena Solo-Gabriele*, PhD, Professor of Engineering
Terry Pitman BS, Web Master
Lisa Regensburg, AMBIENT Teacher Coordinator
Center Investigators
*Center Investigator, **Adjunct Center Investigator, ***Student

Collaborations: Recent research proposals and other activities have involved collaboration with researchers regionally, nationally and internationally as well as with state and Federal agency personnel. Specific activities have ranged from Clinician and public education to seafood testing to collaborative grants and Investigator training.

South Florida: Miami Dade County Public Schools, Miami Dade County Dept of Health, Miami Museum of Science, Royal Caribbean Cruise Lines
State: Florida Depts of Environmental Protection and Public Health; South Florida Water Management District; Health Depts of Florida, Texas, Louisiana, California, Mississippi, Alabama, NC, Maryland, Delaware, Virginia
Federal: NIEHS, Centers for Diseases Control and Prevention (CDC), NOAA/NMFS: interagency Working Group on HAB; NCRR (NIH): The Aplysia Facility; FDA: Seafood Safety Group; SeaGrant (Florida, Puerto Rico); NSF, ECOHAB, Interagency Taskforce on Coastal Issues
Universities: Duke University, University of Tennessee, University of Maryland Center of Marine Biotechnology, University of Washington, Johns Hopkins School of Medicine, University of North Carolina at Wilmington, Harvard University, University of Miami Sylvester Cancer Center, Florida International University, Old Dominion University, Virginia Marine Institute
Other: Mote Marine Laboratory, Miami Seaquarium, National Neurofibromatosis Foundation, South Florida Poison Control, South Florida Aquarium Society, Woods Hole Oceanographic Institute, North Carolina Water Resources Research Institute, Lovelace Respiratory Research Institute, Harbor Branch Oceanographic Institute, Miami Exhibits Inc, American College of Occupational and Environmental Medicine, Society of Behavioral Toxicology, Argentinean National Agency for Food and Agriculture, Gordon Research Conferences, Pan-American Institute of Food and Zoonosis Protection, National Research Council Canada Food Toxins, Pan American Health Organization, World Health Organization, Bermuda Biological Research Station, Audubon of Florida
NIEHS Environmental Centers: Duke University, AUEHSC Center Consortium, Zebra Fish Consortium, Rutgers-UMDMJ

Additional Highlights:

NSF NIEHS Oceans and Human Health Science Symposium (2005)
AMBIENT Investigators participate in Environment Health Perspectives (EHP Journal) High School Teachers Project (2005)
Center COEP participated in NIEHS COEP Booth at American Public Health Association in Philadelphia PA and AAAS Meeting (2005)
NIEHS ARCH- NIEHS MFBS Center Science Symposium (2004)
Center Investigators participated in the National HAB Plan (2004)
Center Investigators participated in Oceans and Human Health: Harmful Algal Blooms Update at Naples Hospital, Naples, FL. (2004, 2005)
Center Investigators participated in the NIEHS funded K-12 AMBIENT Environmental Health Sciences Fourth annual “Teach In” to Dade County Public School Teachers (2004)
Center Investigators presented on COEP and the AMBIENT Program at SOT, APHA, and AAAS
Center Investigator was Key Note Speaker on Overview: Oceans and Human Health at the International Oceans and Human Health Conference, Sardinia, Italy.
Center COEP participated in NIEHS COEP Booth at the American Public Health Association Annual Meeting, San Francisco, CA
Center COEP participated in NIEHS COEP Booth at the American Public Health Association Annual Meeting, San Francisco, CA and Washington, DC and at Society of Toxicology
Center Investigators participated in the South Florida Region ENVIROTHON NIEHS Center/ARCH/NSF NIEHS OHH 2005 Seminars: R Colwell (University of Maryland) Oceans and Human Health; R Fujioka (U Hawaii NIEHS OHHC) Assessment and strategies to address unreliable microbial recreational water quality standards for tropical climates; D McDonald (UM NIEHS MFBSC) The toadfish: stressed, depressed and angry; C. Sinigalliano (FIU SERC/ARCH) Integrating flow cytometry, cell sorting, and molecular applications for the study of toxic algae; D Crawford (UM NIEHS MFBSC) Evolutionary Genomics: Adaptive Variation in Gene Expression; W. Bradley and S. Papaptropoulos (UM School of Medicine) Cyanobacterial toxins, BMAA and Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease); JH Paul (University of South Florida) Protecting Human Health in the Coastal Zone-the Method to our Madness; JM Fleisher (Nova South Eastern University) Risk Perception Bias, Self-Reporting of Illness, and the Validity of Reported Results in an Epidemiologic Study of Recreational Water Associated Illnesses; LE Fleming (NIEHS Center; Key!Notes Lecture Series)Toxic Autumn Colors: Red Tide; LE Fleming (NIEHS Center) Oceans & Human Health; C Lee (University of Alberta) Arsenic Specification and Health Effects; MQ Martindale (University of Hawaii) Cnidarians: springboards (or sink holes?) for the evolution of metazoan complexity; J. Postlethwaite (University of Southern California) Genome duplication and the origin of fish diversity; T Dumonceaux (University of Saskatchewan) Molecular enumeration of intestinal bacteria using quantitative PCR and the chaperonin-60 target; W Carmichael (Ohio State University) Cyanobacteria Harmful Algae Bloom Forensics – Helping the Pieces Fit; G Kirkpatrick (Mote Marine Laboratory) Detecting and tracking the Florida red tide: experiences and expectations;
Annual Distinguished Lecture in Marine Neurosciences Sponsored by the Neuroscience Program & NIEHS Center of the University of Miami: AH Bass (Cornell University) Building a Social Brain: A Tale of Two Males (2004); EL Bearer (Brown University) Axoplasmic transport in the giant axon of the squid: models and mechanisms of human neurologic disease (2003); A Stuart (UNC Chapel Hill, NC); Dr Vision on the rocks: investigating the barnacle's solutions to challenging problems (2002);R Harris-Warrick (Cornell University, NY) Molecular Neuroethology: Roles of potassium channels in a small network (2001); Dr. Jelle Atema, (Boston University, Boston, MA), Tracking Underwater Odor Sources: Lobster Neurobiology, Behavior and Robots (2000);
Center Investigators invited to participate in NIEHS-NSF “Oceans and Human Health Round Table” (2001)
For the Year of the Ocean (May-Sept 1998), the Center was the official Coordinator for the NIEHS scientific exhibitions at the 1998 World Expo “Oceans and Human Health” US Pavilion (Lisbon, Portugal) in collaboration with other NIEHS Centers, NOAA, the US Navy, NAS, and various States. At least 5,000 people attended the exhibit each day from all over the world. The displays included an Aplysia touch tank, interactive computer programs from NIEHS Centers, models of nerve channels and Aplysia, and a touchable iceberg.

Materials and/or Publications:
In addition to the NIEHS Center Website, other materials have been created over the past 14 years of the NIEHS Center by Center Members which are distributed free of charge on request via website, phone, fax, regular mail, and email
(http://www.rsmas.miami.edu/groups/niehs/general/readings.jsp):

AMBIENT Group. Water and Sewage Module High School Environmental Sciences Curriculum. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2001 (www.rsmas.miami.edu/groups/niehs/ambient/).

AMBIENT Group. Soil and Lead Module High School Environmental Sciences Curriculum. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2001.

AMBIENT Group. Air and Asthma Module High School Environmental Sciences Curriculum. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2002.

AMBIENT Group. Food and Foodborne Illness Module High School Environmental Sciences Curriculum. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2002.

AMBIENT Group. Ethics Module. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2003.

AMBIENT Group. Toxicology Module. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2003.

AMBIENT Group. Audubon AMBIENT Module. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2004.

AMBIENT Group. ENVIROTHON Module. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2003, 2004, 2005.

Arena P, Levin B, Fleming LE, Friedman M, Blythe D. Neuropsychologic Effects in Chronic Ciguatera Fish Poisoning. Harmful Algae 2004;3(1):51-60.

Baden D, Fleming LE, Bean JA. Marine Toxins. In: Handbook of Clinical Neurology: Intoxications of the Nervous System Part II. Natural Toxins and Drugs. FA deWolff (Ed). Amsterdam: Elsevier Press, 1995;21(65):141-175.

Baden D, Fleming LE. Brevetoxins. Food and Agriculture Organization/World Health Organization. World Health Organization, Geneva, Switzerland, in press.

Backer L, Fleming LE, Rowan A, Baden D. Epidemiology and Public Health of Human Illnesses Associated with Harmful Marine Phytoplankton. In: UNESCO Manual on Harmful Marine Algae. Hallegraeff GM, Anderson DM, Cembella AD, eds. Geneva, Switzerland: UNESCO/WHO, 2003, pgs 725-750.

Backer LC, Schurz Rogers H, Fleming LE, Kirkpatrick B, Benson J. Phycotoxins in Marine Seafood. In: Chemical and Functional Properties of Food Components: Toxins in Food. Dabrowski W, ed. Boca Raton, FL: CRC Press, 2005, pgs. 155-190.

Backer LC, Fleming LE, Rowan A et al. Recreational Exposure to Aerosolized Brevetoxins During Florida Red Tide Events. Harmful Algae 2003;2:19-28.

Backer LC, Kirkpatrick B, Fleming LE, Cheng YS, Pierce R, Bean JA, Clark R, Johnson D, Wanner A, Tamer R, Baden D. Occupational Exposure to Aerosolized Brevetoxins during Florida Red Tide Events: Impacts on a Healthy Worker Population. Environmental Health Perspectives 2005;113(5):644-649.

Benson JM, Stagner BB, Martin GK, Friedman M, Durr SE, Gomez A, McDonald J, Fleming LE, Backer LC, Bourdelais A, Naar J, Baden DG, Lonsbury-Martin BL. Cochlear function in CBA/CaJ mice following inhalation of brevetoxin-3. J Comparative Physiology in press.

Blythe D, Fleming LE, Ayyar DR, Baden D, De Sylva D, Shrank K. Mannitol Treatment for Acute and Chronic Ciguatera fish Poisoning. Memoirs Queensland Museum 1994;34:465-470.

Blythe DG, De Sylva DP, Fleming LE, Ayyar RA, Baden DG, Schrank K. Clinical Experience with IV Mannitol in the Treatment of Ciguatera. Bull Soc Path Ex 1992;85:425-426.

Cheng YS, Zhou Y, Irvin CM, Pierces RH, Naar J, Backer LC, Fleming LE, Kirkpatrick B, Baden DG. Characterization of Marine Aerosol for Assessment of Human Exposure to Brevetoxins. Environmental Health Perspectives 2005;113(5):638-643.

Dienes H, Fleming LE. Harmful Algal Blooms and Human Health Brochure. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2001.

Dienes H, Fleming LE. NIEHS Center Brochure. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2001.

Easom J, Fleming LE, Steidinger K, Baden D, Rowan A. VideoConference: Florida Harmful Algal Blooms (HABs): Human Health Effects. Funded by CDC and Florida Dept of Health, Miami, FL, June 1999.(video, powerpoint presentation, hardcopy of powerpoint presentation with notes)

Easom J, Fleming LE, Rowan A, Tamer, R, Wiersma S. A Pilot Study of Harmful Algal Bloom Human Health Effects. In: Harmful Algal Blooms 2000. GM Hallegraeff, SI Blackburn, CJ Bolch, RJ Lewis (eds). IOC of UNESCO, Paris 2001, pg 444-446.

Fleming LE, Backer L, Rowan A. The Epidemiology of Human Illnesses Associated with Harmful Algal Blooms. In: Neurotoxicology Handbook, Volume 1. Baden D, Adams D (eds). Totowa, NJ: Humana Press Inc, 2002, pgs 363-381.

Fleming LE, Baden DG. Neurotoxic Shellfish Poisoning: Public Health and Human Health Effects. White Paper for the Proceedings of the Texas Conference on Neurotoxic Shellfish Poisoning, Proceedings of the Texas NSP Conference, Corpus Christi (Texas), April 1998:27-34.

Fleming LE, Kirkpatrick B, Backer LC, Bean JA, Wanner A, Dalpra D, Tamer R, Zaias J, Cheng YS, Pierces R, Naar J, Abraham W, Clark R, Zhou Y, Henry MS, Johnson D, Van de Bogart G, Bossart GD, Harrington M, Baden DG. Initial Evaluation of the Effects of Aerosolized Florida Red Tide Toxins (Brevetoxins) in Persons with Asthma Environmental Health Perspectives 2005;113(5): 650-657.

Fleming LE, Bean JA, Baden D, Brams E. Environmental health in the Caribbean. Journal of Caribbean Studies 1997;12:6-22.

Fleming LE, Bean JA, Baden DG. Epidemiology of Toxic Marine Phytoplankton. In: UNESCO-IOC Manual on Harmful Marine Phytoplankton #33. Hallegraeff GM, Anderson DAN, Cembella AD. Paris: UNESCO, 1995, pgs. 475-488.

Fleming LE, Bean JA, Katz D, Hammond R. The Epidemiology of Seafood Poisoning. Hui, Kits, Stanfield. Seafood and Environmental Toxins. Marcel Dekker, 2001, pg. 287-310.

Fleming LE, Bean JA. Panel Discussion on Marine Toxin Diseases: Epidemiology and Public Health. In: Proceedings of the Workshop Conference on Seafood Intoxication: Pan American Implications of Natural Toxins in Seafood. Baden DG, ed. Miami: University of Miami, 1996, pgs 11-13.

Fleming LE, Blythe D, Baden D. Marine Toxin Diseases: Ciguatera Poisoning. Travel Medicine, 1997;1:1-4.

Fleming LE, Easom J, Baden D, Rowan A, Levin B. Emerging Harmful Algal Blooms and Human Health: Pfeisteria and related organisms. Toxicol Pathol 1999;27:573-581.

Fleming LE, Easom J. Seafood Poisonings. Travel Medicine 1998;2 (10):1-8.

Fleming LE, Stinn J. Shellfish Poisonings. Travel Medicine 1999;3:1-6.

Fleming LE, Washington G. Scombroid Fish Poisonings. Travel Medicine 1998;2(11): 1-5.

Fleming LE, Watkins S, Kaderman R, Levin B, Ayyar DR, Bizzio M, Stephens D, Bean JA. Mercury Exposure in Humans through Food Consumption from the Everglades of Florida. Water Air Soil Pollution 1995;80:41-48.

Fleming, L.E., Baden, D.G., Bean, J.A., Weisman, R., and Blythe, D.G. Seafood toxin diseases: Issues in Epidemiology and community outreach. In: Harmful Algae (B. Reguera, J. Blanco, M.L. Fernandez, and T. Wyatt, Eds.) Xunta de Galicia and Intergovernmental Oceanographic Commission of UNESCO 1998, pp. 245‑248.

Fleming LE, Rivero C, Burns J, Williams C. Final Report: Blue Green Algal Exposure, Drinking Water and Colorectal Cancer. The Florida Harmful Algal Bloom Taskforce, October 2001.

Fleming LE, Solo Gabriele H, Elmir S, Shibata T, Squicciarini D, Quirino W, Arguello M, Van De Bogart G. A Pilot Study of Microbial Contamination of Subtropical Recreational Waters. Fl J Env Health March 2004;29-33.

Fleming LE, Stephan W. Blue Green Algae, Their Toxins and Public Health Issues. The Florida Harmful Algal Bloom Taskforce, October 2001.

Fleming LE, Rivero C, Burns J, Williams C, Bean J, Shea K, Stinn J. Blue Green Algal (Cyanobacterial) Toxins, Surface Drinking Water, and Liver Cancer in Florida. Harmful Algae 2002;1(2):157-168.

Fleming LE, Backer LC, Baden DG. Overview of Aerosolized Florida Red Tide Toxins: Exposures and Effects. Environmental Health Perspectives 2005;113(5):618-620.

Fleming LE, Rivero C, Burns J, Williams C, Bean JA, Stephan WB. Cyanobacteria Exposure, Drinking Water and Colorectal Cancer. In: Harmful Algae 2002. Proceedings of the Xth International Conference on Harmful Algae. Steidinger KA, Landsberg JH, Tomas CR, Vargo GA (eds).Florida Fish and Wildlife Conservation Commission and Intergovernmental Oceanographic Commission of UNESCO, 2004.

Fleming LE, Backer LC, Kirkpatrick B, et al. An Epidemiologic Approach to the Study of Aerosolized Florida Red Tides. In: Harmful Algae 2002. Proceedings of the Xth International Conference on Harmful Algae. Steidinger KA, Landsberg JH, Tomas CR, Vargo GA (eds) Florida Fish and Wildlife Conservation Commission and Intergovernmental Oceanographic Commission of UNESCO, 2004.

Friedman MA, Levin BE. Neuropyschological effects of Harmful Algal Bloom (HAB) toxins: a literature review. J International Neuropsychol 2005;11:331-338

Kirkpatrick B, Fleming LE, Backer LC, Bean JA, Tamer R, Kirkpatrick G, Kane T, Wanner A, Dalpra D, Kane T, Wanner A, Dalpra D, Reich A, Baden DG. Environmental exposures to Florida red tides: effects on emergency room respiratory diagnoses admissions. Harmful Algae in press

Kirkpatrick B, Fleming L, Squicciarini D, Backer LC, Clark R, Abraham W, Benson J, Cheng YS, Johnson D, Pierce R, Zaias J, Bossart G, Baden DG. Literature review of Florida Red Tide: implications for human health. Harmful Algae Vol 2004;3(2):99-115.

Knap A, Dewailly E, Furgal C, Galvin J, Baden D, Bowen B, Depledge M, Duguy L, Fleming LE, Ford T, Moser F, Owen R, Suk W, Unluata U. Indicators of Ocean Health and Human Health: A Research Framework. Environmental Hlth Perspect 2002;110:839-845.

Levin B, Arena P, Fleming LE, Blythe D. A Pilot Study of the Cognitive and Psychological Correlates of Chronic Ciguatera Poisoning. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2001.

McKee D, Fleming LE, Tamer R, Weisman R. Ciguatera Fish Poisoning Reporting by physicians in an endemic area. In: Harmful Algal Blooms 2000. GM Hallegraeff, SI Blackburn, CJ Bolch, RJ Lewis (eds). IOC of UNESCO, Paris 2001, pg 451-453.

Okamoto K, Fleming LE. Algae. In: Encyclopedia of Toxicology (2nd edition). Wexler P, editor. Oxford, England: Oxford University Press, 2005, Volume 1, pgs 68-76.

Pierce RH, Henry MS, Bloom PC, Hamel SL, Kirkpatrick B, Cheng YS, Zhou Y, Irvin CM, Naar J, Weidner A, Fleming LE, Backer LC, Baden DG. Brevetoxin Composition in Water and Marine Aerosol along a Florida Beach: Assessing Potential Human Exposure to Marine Biotoxins. Harmful Algae 2005;4/6:965-972.

Quirino W, Fleming LE, Weisman R, Backer L, Kirkkpatrick B, Clark R, Dalpra D, Van de Bogart G, Gaines M. Follow up study of red tide associated respiratory illness. Fl J Env Health 2004;186:18-22.

Rabinsky R, Fleming LE. Philosophical insights from an analysis of media coverage of the Pfiesteria controversy. In: Harmful Algae 2002. Proceedings of the Xth International Conference on Harmful Algae. Steidinger KA, Landsberg JH, Tomas CR, Vargo GA (eds).Florida Fish and Wildlife Conservation Commission and Intergovernmental Oceanographic Commission of UNESCO, 2004.

Red Tide Research Group. The Current of Red Tide Research. Env Health Persp 2002;110(3):132-133.

Red Tide Group. Florida Red Tide & Human Health Brochure. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, Miami, FL, April 2002.

Shibata T, Solo Gabriele HM, Fleming LE, Elmir S. Monitoring Marine Recreational Water Quality Using Multiple Microbial Indicators in an Urban Tropical Environment. Water Research 2004;38:3119-3131.

Shibata T, Solo-Gabriele HM, Fleming LE, Shalat SL, Cai Y, Townsend T.G. 2005. Potential arsenic exposure to children associated with in-service and recycled CCA-treated wood in tropical environments. WIT Transactions on Ecology and the Environment (ISSN 1743-3541) Environmental Exposure and Health. 2005;85349-365.

Solo Gabriele H, Fleming L, Elmir S, et al. A Pilot Study Evaluation of the Microbial Recreational Water Indicators in the Subtropical Marine Environment. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2002.

Stephan W, Fleming LE. “Have you been Slimed?” (Educational Poster). The Florida Harmful Algal Bloom Taskforce, October 2001.

Stephan W, Fleming LE. Frequently Asked Questions About Blue Green Algae (Cyanobacteria) and Their Toxins. The Florida Harmful Algal Bloom Taskforce, October 2001.

Stephan W, Fleming LE. Ciguatera Fish Poisoning Brochure and Poster. CDC/Florida Dept of Health, 2004.

Stewart I, Webb PM, Schulter PJ, Fleming LE, Burns JW, Gantar M, Backer LC, Shaw GR. Acute effects of recreational exposure to freshwater cyanobacteria – a prospective epidemiologic study. In: Harmful Algae 2002. Proceedings of the Xth International Conference on Harmful Algae. Steidinger KA, Landsberg JH, Tomas CR, Vargo GA (eds) Florida Fish and Wildlife Conservation Commission and Intergovernmental Oceanographic Commission of UNESCO, 2004

Stewart I, Fleming L, Gantar M, Burns J. Recreational exposure to freshwater cyanobacteria. NIEHS Marine and Freshwater Biomedical Sciences Center, University of Miami, 2003.

Stewart I, Webb PM, Schluter PJ, Fleming LE, Burns JW, Gantar M, Backer LC, Shaw GR. Epidemiology of recreational exposure to freshwater cyanobacteria - an international prospective cohort study. BMC Public Health in press

Stinn JF, De Sylva DP, Fleming LE, Hack E. Geographic Information Systems (GIS) and ciguatera fish poisoning in the tropical Western Atlantic region. Proceedings of the 1998 Geographic Information Systems in Public Health, Third National Conference San Diego, CA. http://www.atsdr.cdc.gov/gis/conference98/proceedings/html/stinn.html, 2000.

University of Miami NIEHS Center and NIEHS 1998 World Expo Touch Screen CD of Oceans and Human Health Issues. Funded by the NIEHS, 1998.

Weisman R, Baden D, Fleming LE. Ciguatera. World Health Organization Emergency Response Manual. World Health Organization, Geneva, Switzerland, in press.

Contact:

Lora E Fleming MD PhD MPH MSc, COEP Director and Center Associate Director Associate Professor
University of Miami
School of Medicine
Department of Epidemiology and Public Health
PO Box 016069 (R-669)
Miami, FL 33101
Phone: 305-243-5912 or 305-361-4736
Fax: 305-243-3384 or 305-361-4001
E-mail: lfleming@med.miami.edu

Web Page Address : http://www.rsmas.miami.edu/groups/niehs/