Articles and Publications

Practical Guidelines for Evaluating Lead Exposure in Children with Mental Health Conditions: Molecular Effects and Clinical Implications
by PEHSU staff Drs. Burke and Miller
Postgraduate Medicine, Volume 123, Issue 1, January 2011 (with permission of the publishers)

In this article, we review some of the clinical and scientific challenges that relate to the assessment and treatment of children presenting for mental health care who may have potential lead exposure

Pediatric Perspectives on Environmental Health
by UCSF PEHSU staff Drs. Miller and Brock-Utne
Chapter 32 of Integrative Pediatrics, Editors Timothy Culbert and Karen Olness. This is part of the Weil Integrative Medicine Library. Oxford University Press, 2010.

Human health should be considered within the context of the larger ecosystem, social systems, and other influences. This paper addresses medical practitioners embracing an integrative approach. It encourages them to include environmental health when advocating for holistic health policy and practice, one that recognizes the interdependence of human health and the larger ecosystem.

Thyroid-Disrupting Chemicals: Interpreting Upstream Biomarkers of Adverse Outcomes
Miller MD, Crofton KM, Rice DC, Zoeller RT
Environmental Health Perspectives 117:1033*1041 (2009).

Background: There is increasing evidence in humans and in experimental animals for a relationship between exposure to specific environmental chemicals and perturbations in levels of critically important thyroid hormones (THs). Identification and proper interpretation of these relationships are required for accurate assessment of risk to public health.

We review the role of TH in nervous system development and specific outcomes in adults, the impact of xenobiotics on thyroid signaling, the relationship between adverse outcomes of thyroid disruption and upstream causal biomarkers, and the societal implications of perturbations in thyroid signaling by xenobiotic chemicals. Data sources: We drew on an extensive body of epidemiologic, toxicologic, and mechanistic studies.

Outcomes of the California Ban on Pharmaceutical Lindane: Clinical and
Ecologic Impacts
By UCSF PEHSU staff and collaborators Humphreys EH, Janssen S, Heil A, Hiatt P, Solomon G, Miller MD.
in Environmental Health Perspectives, 2008 Mar;116(3):297-302.

Conclusions: The California experience suggests that elimination of pharmaceutical lindane produced environmental benefits, was associated with a reduction in reported unintentional exposures, and did not adversely affect head lice and scabies treatment. This ban serves as a model for governing bodies considering limits on the use of lindane or other pharmaceuticals.

Environmental Risk Communication for the Clinician
By UCSF PEHSU staff Drs. Miller and Solomon
in Pediatrics Vol. 112 No. 1 July 2003;112:211*217;

Although they are accustomed to discussing risks in the medical arena through the process of informed consent, primary care clinicians may have difficulty communicating with their patients and communities about environmental health risks. Clinicians are generally trusted and can play important roles as educators, alert practitioners, or even advocates talking about environmental health risks with individuals and groups. Communication of risk requires an understanding of how scientists and clinicians assess risk the process of quantitative or qualitative risk assessment. Risk is never a purely scientific issue; risk is perceived differently depending on some well-understood characteristics of the hazard, the individual perceiving the risk, and the social context. Many low-income communities of color have faced and continue to face disproportionate environmental exposures and disease burdens. The issue of environmental justice can significantly affect the context of a discussion about a specific environmental risk. The essence of risk communication has been well described and requires careful evaluation of the science and the social context, honesty, listening to and partnering with the community, and a clear, compassionate team approach.