Professor of Medicine
Division of Occupational and Environmental Medicine
University of California, School of Medicine
San Francisco, CA 94143-0843
john.balmes@ucsf.edu
UCSF: 415-206-8953 | Fax: 415-206-8949
UCB: 510-643-4702 | Fax: 510-642-5815
http://coeh.berkeley.edu/ucsfoem/
 
Creative Achievements
Demonstrated that:
• People with asthma have increased airway inflammation after exposure to ozone compared to those without asthma;
• Supplemental vitamin A and beta-carotene do not protect workers exposed to asbestos from lung cancer;
• Wildland firefighters have decreased lung function after a fire season as compared to their pre-season baseline values;
• There is attenuation of the inflammatory response to ozone with exposure on several, consecutive days.
 
Current Research Interests
• Effects of ozone on persons with asthma (controlled human exposure study)
• Chronic effects of ozone on lung function (epidemiologic, controlled human exposure study)
• Effect of nitrogen dioxide on allergic airway inflammation in persons with asthma
• Risk of lung cancer and cardiovascular mortality
• Respiratory effects of inhaled particulate matter (controlled human exposure studies)
• Effects of air pollution on the natural history of asthma in children

Dr. Balmes received his M.D. degree from Mount Sinai School of Medicine in 1976. After internal medicine training at Mount Sinai and pulmonary subspecialty, occupational medicine, and research training at Yale, he joined the faculty of USC in 1982. He joined the faculty at UCSF in 1986 and is currently Professor and Division Chief of Occupational and Environmental Medicine at San Francisco General Hospital (SFGH). His major academic activities include his research laboratory, several collaborative epidemiological research projects, various advisory and editorial committees, and direction of the clinical occupational/environmental medicine division at SFGH.

Dr. Balmes' laboratory, the Human Exposure Laboratory (HEL), has been studying the respiratory health effects of various air pollutants for the past 18 years. Recently, the HEL has been focusing on the airway inflammatory effects of ozone, secondhand tobacco smoke, and wood smoke. The HEL was the first group to demonstrate a) histological evidence of ozone-induced airway injury and inflammation in human subjects, b) that asthmatic subjects have greater inflammatory responses to ozone than normal subjects, c) that ozone-induced inflammatory responses in normal subjects attenuate with short-term exposures on consecutive days in the lung, and d) that asthmatic subjects recruit macrophages to the airways with consecutive day exposures. The lab is currently studying the impact of a genetic polymorphism of the antioxidant enzyme, Glutathione-S-transferase M1, on the susceptibility of asthmatic subjects to ozone. We are also studying the relationship of acute airway inflammatory responses to acute cardiovascular responses after both ozone and secondhand tobacco smoke.

Dr. Balmes is also collaborating on several epidemiological projects. One such project is called the "Fresno Asthmatic Children's Environment Study" (FACES). The overall specific aim of FACES is to determine the relationship between air pollution-induced short-term exacerbations of childhood asthma and the longer-term course of asthma. A cohort of 250 asthmatic children (ages 6-11) is being followed longitudinally with serial measurements of lung function and assessment of asthma severity (symptoms, medication use) as well as serial measurement of both indoor and outdoor exposures. A second project (CRECER) involves longitudinal study of the effects of biomass smoke exposure on chronic respiratory health of ~500 young children in rural Guatemala. A third line of research involves the effects of arsenic in drinking water on lung health in both Bangladesh and Chile.  Yet another project involves the effect of chronic exposure to hydrogen sulfide on lung function in Rotorua, NZ.

Teaching
• Introduction to Clinical Medicine (for second-year UCSF medical students)
• Occupational and Environmental Medicine (UCSF CME course)
 
Honors
• Environmental/Occupational Medicine Academic Award, NIEHS, 1991-1996

Key Publications
• Chen C, Arjomandi M, Tager IB, Holland N, Balmes J.  Effects of antioxidant enzyme polymorphisms on ozone-induced lung function changes.  Eur Respir J 2007; 30:677-683.
• Chen C, Arjomandi M, Balmes J, Tager I, Holland N.  Effects of chronic and acute ozone exposure on lipid peroxidation and antioxidant capacity in healthy young adults.  Environ Health Perspect 2007;115:1732-1737.
• Heiss C, Amabile N, Lee AC, Real WM, Schick SF, Lao D, Wong ML, Sarah Jahn S, Angeli FS, Minasi P, Springer ML, Hammond SK, Glantz SA, Grossman W, Balmes JR, Yeghiazarians Y.  Brief secondhand smoke exposure depresses EPC activity and endothelial function: sustained vascular injury and blunted NO production.  J Am Coll Cardiol 2008;51:1760-1771.
• Blanc P, Iribarren C, Trupin L, Earnest G, Katz P, Balmes J, Sidney S, Eisner M,.  Occupational exposures and the risk of COPD: dusty trades revisited.  Thorax 2009;64:6-12.
• Balmes JR, Earnest G, Katz PP, Yelin EH, Eisner MD, Chen H, Trupin L, Lurmann F, Blanc PD.  Exposure to traffic: lung function and health status in adults with asthma.  J Allergy Clin Immunol 2009;123:626-631.
• Arjomandi M, Seward J, Gotway MB, Nishimura S, Fulton GP, Thundiyil J, King TE, Harber P, Balmes J. Low prevalence of chronic beryllium disease among workers at a nuclear weapons research and development facility.  J Occup Environ Med 2010;52:647-652.
• Mann JK, Balmes JR, Bruckner TA, Mortimer KM, Margolis HG, Pratt B, Hammond SK, Lurmann F, Tager IB.  Short-term effects of air pollution on wheeze in asthmatic children in Fresno, California.  Environ Health Perspect 2010;118:1497-502.
• Nadeau K, McDonald-Hyman C, Noth EM, Pratt B, Hammond SK, Balmes J, Tager I. Ambient air pollution impairs regulatory T-cell function in asthma. J Allergy Clin Immunol 2010;126:845-852.
• Dauphiné DC, Ferreccio C, Guntur S, Yuan Y, Hammond SK, Balmes J, Smith AH, Steinmaus C. Lung function in adults following in utero and childhood exposure to arsenic in drinking water: preliminary findings. Int Arch Occup Environ Health (in press) 2011.
• Smith KR, McCracken JP, Weber MW, Hubbard A, Jenny A, Thompson L, Balmes J, Diaz A, Arana B, Bruce N.  RESPIRE: A Randomised Controlled Trial of the impact of reducing household air pollution on childhood pneumonia in Guatemala.  The Lancet (in press) 2011.

Public and University Service
• Acting Director, Center for Occupational and Environmental Health
• Director, UCSF Occupational Medicine Residency Program, 1990-present
• Chair, Scientific Assembly on Environmental and Occupational Health, American Thoracic Society, 1997-1999
• Member, Safety and Occupational Health (SOH) study section, NIOSH, 1996-2000
• Member, Research Screening Committee, California Air Resources Board, 1998-present
• Member, Air Quality Advisory Committee, Cal/EPA