John Balmes

John R. Balmes, MD

Professor of Medicine
Division of Occupational and Environmental Medicine
University of California, San Francisco, School of Medicine
San Francisco, CA 94143-0843

Professor of Environmental Health Sciences
University of California, Berkeley, School of Public Health
Berkeley, CA 94720-7360

UCSF: 415-206-8953
UCB: 510-643-4702
Creative Achievements
Demonstrated that:

  • People with asthma have increased airway inflammation after exposure to ozone compared to those without asthma;
  • Wildland firefighters have decreased lung function after a fire season as compared to their pre-season baseline values;
  • Air pollution in California’s San Joaquin Valley is associated exacerbations of asthma and decreased lung function in children;
  • Occupational exposures to vapors, gases, dusts, and fumes increase the risk of chronic obstructive pulmonary disease;
  • Short-term exposure to secondhand tobacco smoke causes acute cardiovascular effects;
  • A chimney stove intervention (compared to a traditional open fire) can reduce risk of early childhood pneumonia in rural Guatemala.

Current Research Interests

  • Effects of exposure to outdoor air pollution on respiratory and cardiovascular health, immune and glucose dysregulation, and obesity in children and adults
  • Effects of exposure to household air pollution (from combustion of biomass fuels for domestic cooking) on respiratory and cardiovascular health in children and adults
  • Effects of early-life exposure to pesticides on respiratory health later in the life course
  • Effects of arsenic in drinking water on respiratory health
  • Interactive health effects of exposures to air pollution and psychosocial stress

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). He joined the faculty at the School of Public Health at UC Berkeley in 2002. His major academic activities include his research laboratory, several collaborative epidemiological research projects, various advisory and editorial committees, and direction of the COEH since 2000.

Dr. Balmes' laboratory, the Human Exposure Laboratory (HEL), has been studying the respiratory and cardiovascular health effects of various air pollutants for over 25 years. Recently, the HEL has been focusing on the acute 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 asthmatic subjects recruit macrophages to the airways with consecutive day exposures, and d) exposure to secondhand tobacco smoke causes endothelial dysfunction. 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 the combined effects of an allergen and 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 Children's Health Air Pollution Study (CHAPS). The overall specific aim of CHAPS is to determine relationships between air pollution and children’s health, including birth defects, pre-term birth, asthma, immune function, obesity, and glucose dysregulation. A second project Chronic Respiratory Effects of Early Childhood Exposure to Respirable Particulate Matter (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 Chile. Yet another project, involves the effect of chronic exposure to hydrogen sulfide on asthma and lung function in Rotorua, New Zealand (

Occupational and Environmental Lung Disease, Interdepartmental Studies 102b (UCSF)

Introduction to Environmental Health Sciences, PH 150b (undergraduate) and PH 270 (graduate) (UC Berkeley)

  • ATS Public Service Award in Recognition of Outstanding Contributions in Public Health in the area of Respiratory Disease and Medicine, American Thoracic Society, 2016
  • John M. Peters Award in Appreciation of a Lifetime of Leadership, Research, and Devoted Service to the Pursuit of Respiratory Health, American Thoracic Society's Assembly on Environmental, Occupational and Population Health, 2016
  • Robert M. Zweig Memorial Clean Air Hero Award, South Coast Air Quality Management District, 2012
  • Western Occupational and Environmental Medical Association, 2010
  • Rutherford T. Johnstone Award for Exemplary Contributions to the Field of Occupational Medicine, 2010
  • Carl Moyer Award for Scientific Leadership and Technical Excellence, Coalition for Clean Air, 2006
  • Robert A. Kehoe Award for Excellence in Education or Research in Occupational and Environmental Medicine, American College of Occupational and Environmental Medicine, 2006
  • Jean Spencer Felton Award for Excellence in Scientific Writing, Western Occupational and Environmental Medicine Association, 2002
  • Clean Air Award, American Lung Association of California, 1999
  • Clean Air Research Award, American Lung Association of San Francisco and San Mateo, 1997
  • Environmental/Occupational Medicine Academic Award, NIEHS, 1991-1996

Selected Recent Publications

  • Heinzerling AP, Guarnieri MJ, Mann JK, Diaz JV, Thompson LM, Diaz A, Bruce NG, Smith KR, Balmes JR. Lung function in woodsmoke-exposed Guatemalan children following a chimney stove intervention. Thorax 2016;71(5):421-428.
  • Reid CE, Jerrett M, Tager IB, Petersen ML, Mann JK, Balmes JR. Differential respiratory health effects from the 2008 northern California wildfires: A spatiotemporal approach. Environ Res 2016;150:227-235.
  • Raanan RA, Gunier RB, Balmes JR, Beltran AJ, Harley KG, Bradman A, Eskenazi B. Decreased lung function in 7-year-old children with early-life organophosphate exposure. Thorax 2016 Feb;71(2):148-153.
  • Nishimura KK, Galanter JM, Arjomandi M, Wong H, Donde A, Frelinger J, Dalton S, Ching W, Power K, Balmes J. Exposure to medium and high ambient levels of ozone causes adverse systemic inflammatory and cardiac autonomic effects. Am J Physiol Heart Circ Physiol 2015 Jun 15;308(12):H1499-509.
  • Steinmaus C, Ferreccio C, Yuan Y, Acevedo J, González,F, Perez L, Cortés S, Balmes JR, Liaw J, Smith AH. Elevated lung cancer in younger adults and low concentrations of arsenic in water. Am J Epidemiol 2014; 180(11):1082-7.
  • Guarnieri MJ, Diaz JV, Basu C, Diaz A, Pope D, Smith KR, Smith-Sivertsen T, Bruce N, Solomon C, McCracken J, Balmes JR. Effects of woodsmoke exposure on airway inflammation in rural Guatemalan women. PLoS One 2014;9:e88455.
  • Roth LA, Oh SS, Thakur N, Nguyen EA, Thyne S, Farber HJ, Serebrisky D, Kumar R, Brigino-Buenaventura E, Davis A, Lenoir MA, Meade K, Rodriguez-Cintron W, Avila PC, Borrell LN, Bibbins-Domingo K, Rodriguez-Santana JR, Sen S, Lurmann F, Balmes JR, Burchard E. Early life air pollution and asthma risk in minority children: The GALA II and SAGE II Studies. Am J Respir Crit Care Med 2013;188(3):309-318.
  • 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 2011;378(9804):1717-1726.
  • 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.

Additional publications:

Public and University Service

  • Professor of Medicine, UCSF
  • Attending Physician, Divisions of Pulmonary/Critical Care Medicine and Occupational/Environmental Medicine, Zuckerberg San Francisco General Hospital, 1986-present
  • Director, Northern California Center for Occupational and Environmental Health (UC Berkeley-UC Davis-UCSF)
  • Director, the UC Berkeley-UCSF Joint Medical Program 
  • Physician Member, California Air Resources Board, 2008-present