Our previous research has shown that exposure to contaminants in outdoor and  indoor air can affect respiratory health, especially in children.  This is important because diseases such as asthma, bronchitis and other conditions are very common and affect many families. 

We have also previously written about how children show exposure to endocrine disrupting chemicals from personal care products and other sources.   Recently, I was interviewed by Kelly Bryant for an article in Reader's Digest.  The article lists 14 ways in which toxins "sneak" into our homes in ways that may be unexpected or surprising for many people.  I was quoted in the article as follows:
It feels good to put dry-cleaned clothing back in your closet, crisp and pressed for your next outing. But the process which made them look brand new could carry some trouble. “Perchloroethylene is a chemical used in dry cleaning,” says Luz Claudio, PhD, professor of environmental medicine at the Icahn School of Medicine in New York. “Although it’s not known how much of it may be released in the home when you bring dry-cleaned clothes in plastic bags, it may be best to open the bags and aerate them outdoors before bringing inside.”
The other 13 sneaky ways toxins may be entering your house, according to the article, are: 

• Through the floorboards in the form of radon, a gas that can lead to lung cancer after prolonged exposure.
• With new carpets that emit volatile organic compounds, especially during the first 72 hours after installation.
• Your mattresses when they are treated with toxic flame retardants.
• Air fresheners as the perfumes and scents can contain toxic chemicals.
• "Natural" products with labels that can be misleading.
• Indoor air products that are intended to perfume or mask odors in the air.
• Household dust can accumulate and concentrate many of the non-volatile toxins that exist in the home.
• Self-care products such as nail polish, shampoo, and others may release formaldehyde, which causes cancer.
• "Safe" ingredients such as polyethylene glycol are very common in cosmetics and cleaning products.  The Environmental Working Group and others question the safety of these ingredients.
• On your shoes you can bring anything that you walked on outdoors including bacteria and other organisms.
• In your walls can be lurking mold which can be an asthma trigger, especially in children.
• From the tap water in as many as 33 states have been found to have unsafe levels of several chemicals.  
• Through your air conditioner, when not well designed or maintained, can contribute to concentrating polluted indoor air. 

To read the full article, visit the Reader's Digest website.  Click below.

Guest Blog Post: Dr. Bahby Banks was one of my first students in the International Training Program.  After completing her doctoral degree, she has become a successful business owner, motivational speaker, and consultant.  She helps other women of color envision their futures and helps businesses evaluate their programs.  She is always a welcome guest speaker for our group of new students.  
Here is Bahby's story in her own words. ​

I participated in the inaugural Mount Sinai School of Medicine (MSSM) Exchange Program for Minority Students in 2006, shortly after I completed the first year of my doctoral studies at UNC Gillings School of Public Health.   My research internship included placements at Fundacão Oswaldo Fiocruz in Rio de Janiero, Brazil and Hospital Alvarez in Buenos Aires, Argentina.  Dr. Claudio did an amazing job of preparing us for our internships, including a week-long orientation in New York City. During this week, we were introduced to local researchers and scientists, provided with instructional language CDs and given literature that detailed the importance of inclusion of underrepresented populations in research.  Every single detail of orientation week wreaked “love” and “investment” from Dr. Claudio and her staff.
After orientation, I made my way to my first placement at Fundacão Oswaldo Fiocruz, where I worked with Drs. Lucia Rotenburg and Rosane Greip to explore gender differences in work ability among Brazilian nurses. My lab consisted of about five young researchers—all women- who investigated various aspects of Dr. Rotenburg’s research.  My work with the Fiocruz team continued after I returned to United States, and resulted in a peer-reviewed publication (Rotenberg L, Portela LF, Banks B, Griep RH, Fischer FM, Landsbergis P. A gender approach to work ability and its relationship to professional and domestic work hours among nursing personnel. Appl Ergon. 2008;39(5):646-52)! The following year, I traveled with Dr. Rotenburg to the 18th International Symposium on Shiftwork and Working Time in Australia—where I was the only delegate from the United States.  Quite an honor!  
My second placement in 2006 was in Buenos Aires with Dr. Diana Gilamberti, director of Obstetrics and Gynecology (OB/GYN) at Hospital Alvarez.  I worked with another Mount Sianai intern to develop a survey to explore the use of petroleum-based lubricants among sex workers receiving services in the OB/GYN department.   This was probably one of the most intriguing experiences that I’d as a budding researcher, as Dr. Gilamberti invited us to share the survey findings with two sex worker union representatives in Buenos Aires.  The representatives responded with such passion and were adamant about prioritizing the safety and health of “their girls”.  The response to raise awareness about the dangers of petroleum-based lubricant use was the quickest I hade seen for any public health effort.  By the end of my internship, the local health department began supplying the hospital with condoms packaged with lubricants.  They also made them available at the local health department.
My journey to become founder and CEO of Pillar Consulting, Inc. was a very non-traditional one.  I knew very early on during my doctoral training that I wanted to serve as a faculty member and independent research consultant.  I did not, however, have a “roadmap” to guide how I could navigate both of these roles successfully.  I had a powerful network of mentors to guide my steps in academia, offering opportunities to contribute to research in historically oppressed communities.  Opportunities did not always present themselves in “traditional” ways, but I was very proactive in seeking leadership and research roles that supplemented my academic training.  Many of my mentors, including Dr. Claudio, were not in my department, but they were invested in my growth as a researcher.
The most powerful shift as a research intern was learning my role as a contributor to research.  The Impostor syndrome is very real, particularly for people navigating industries that have historically excluded women and racial and ethnic minorities.  I did not always feel that I belonged—despite doing all of the work to earn my seat in the room. But, sitting alongside senior women researchers who successfully navigated the academy was priceless.  It was a mirror of sorts for where I wanted to be after I completed my studies. 
Two things I learned over the course of my training: 1) Your work will always speak for you and 2) Think outside of the box.  My applying for the Mount Sinai International Exchange Program for Minority Students was an example of the latter, as this type of training program was not available at my home institution.  I participated in several internships over the course of my studies, and while the variation in topic areas appeared as a “lack of focus” to some faculty, I knew exactly how these opportunities could build my professional portfolio.  I knew that I wanted to add international training to my professional portfolio, and these internships afforded the opportunity to supplement the training I was learning in the classroom. As a result of seizing these opportunities, I was able to conduct research at the World Health Organization, Fundacão Oswaldo Cruz, Hospital Alvarez, and ultimately worked with an amazing research team in rural North Carolina.

My love for program evaluation and mixed-method approaches led to my current career as a business owner and independent research consultant.  During my doctoral studies, I enrolled in courses and took advantage of external training opportunities to develop my research skills (e.g., qualitative methodology, racial and equity training, community-based research).  Business development took a little more work, as I didn’t know any researchers navigating the path of entrepreneurs! I did, however, reach out to several men and women in my network who were entrepreneurs to glean what wisdom I could to position Pillar Consulting as a competitive company.   Networking was key!

I share with my mentees the importance of having a “tangible” when they complete a research internship—something that documents their contribution to the research.  This “tangible” might vary from place to place: a conference poster, oral presentation, brief, video or peer-reviewed publication.  No matter the case, the goal is to share your findings.  Dissemination is key in ensuring your work, and the work of the communities you serve.  As an academician, peer-reviewed publications are essential to building your tenure package.  Scientific writing in essential to sharing your work with the Academy. 
 
Now, as a business owner, I focus most of my work with Pillar Consulting on historically oppressed populations whose voices have not been part of “best practices” shared in the literature. That said, we work with clients to help build their capacity to lead and contribute to the dissemination of their work.  We, as research scientists, continue to partner across the county to disseminate the work of our partners.
 
Participating in Dr. Claudio’s internship helped me achieve my career goals.  There is power in being able to say that part of your academic training included contributions in national and international settings.  By the time I completed my Ph.D., I had co-authored several peer-reviewed publications in national and international journals, presented at conferences around the world and had a vast network of colleagues around the globe. These opportunities laid the foundation for me to become the researcher I am today!
 
I would not be where I am today without mentors who were invested in my success and growth as a public health researcher. As a military dependent, I was accustomed to being in a variety of academic settings—public, private, predominantly White, or predominantly Black—but I was the first (but not last) member of my family to pursue doctoral training.  In more ways than one, there was no a roadmap for me to follow.  My mentors, near and far, were open and transparent about their journeys in research, and pushed me to raise the bar for myself.  They believed in me when I didn’t believe in myself and challenged me to (literally) use my voice at the decision-making table.  They helped me see my dual role as a trainee and contributor to research.
I continue to grow as a leader and evaluation researcher every day.  My goal of building community capacity in research has not changed, but my approach has.   My team is committed to working with an equity-based lens. We are working with partners whose approaches include social determinants of health and structural-based approaches to improving the human condition.

What I say to new students in these internship programs is this: Use your voice.  In the words of the late Shirley Chisholm, “If they don't give you a seat at the table, bring a folding chair.”

Photo credit: Jessica Valdez Outlasting Memories.

I am the proud daughter of two amazing parents who emigrated from Mexico in pursuit of the American dream and the hope for a better future for their children.  Despite their long work hours, my father as a factory worker and my mother as a seamstress, they always stressed the importance of education.  We learned through their hard work and motivation that good grades and college were the only option for a better future. 

I was the first person in my family to attend college.  I earned a Bachelor of Science degree in health education at California State University, Northridge and furthered my passion for health education at New Mexico State University (NMSU), where I obtained a Master of Public Health (MPH) degree.  But it was the opportunity, mentorship and influence of Dr. Luz Claudio that inspired me to obtain my Doctorate in Health Education after completing a physician assistant degree.  Little did I know my pursuit of a doctorate would serve as the catalyst to that which makes me most proud: the opportunity and experiences of serving individuals and families in underserved communities.  These opportunities have fulfilled my moral desire and innate obligation to give back.

While obtaining my MPH at NMSU in Las Cruces, I worked for the New Mexico Department of Health.  Much of that work was spent investigating the indoor toxic pollutants that exacerbate asthma, specifically in the rural communities in and around Las Cruces.  This work was so impactful to my life that I continued to conduct research on childhood asthma in vulnerable populations.  It was during that time I learned of Dr. Luz Claudio’s Environmental Research Program.  So after completing my first year at NMSU, I applied to the program and was subsequently selected as a participant for the Summer 2002 program.  

This opportunity allowed me to further research childhood asthma as a participant of the Environmental and Occupational Fellowship Program at the Department of Environmental Medicine and Public Health at Mount Sinai in New York.  This experience forever shaped my life as a health care provider and advocate for our most vulnerable populations.  I attribute the success of this experience in large measure to the leadership and mentoring of Dr. Luz Claudio and to the other remarkable program participants.

As part of the program, my research involved developing and disseminating materials to families who repeatedly experienced asthma exacerbations and included developing and evaluating culturally effective asthma education programs for communities in and around Harlem, New York.  Given the prevalence rate of childhood asthma, which was strikingly high, we noted alarming hospitalization rates in this population when compared with those living in affluent communities.  We attributed much of these results to a lack of health care resources and information within these communities.  Given the many families using the emergency room for medical care services coupled with the limited time emergency room physicians have to treat patients, we determined that this population had significantly limited comprehensive health care, which is necessary for treating chronic conditions like asthma, and required better patient education about the condition and preventing exacerbations.
​
My role in mitigating the disparities between the social determinants and inequalities of health and these vulnerable populations would be the beginning of a much greater task.  For instance, many of the children lived in poverty-stricken areas with poor housing conditions, which exposed them to asthma triggers that often worsened their condition.  Most families were completely unaware that environmental factors, outdoor and indoor, could trigger an asthma attack.  Because of the knowledge-based perspective of research Dr. Claudio and the program experience provided, the other students and I were able to identify and provide solutions to problems.

The opportunity to work with these families and contribute to the overall improvement in the health of children with asthma in Harlem, New York, was an honor.  Further, this experience served as a stepping-stone for the continuation of my research in the area of childhood asthma and investigations into the health disparities among children diagnosed with asthma living in underserved rural areas of New Mexico and Arizona.

As a physician assistant for the last 14 years, I continue my commitment to working with vulnerable populations and providing medical care to those with the most need.  Although I mainly work in a family practice in a predominately Latino underserved community, during the past year I have been volunteering at various churches throughout Arizona to provide medical care for immigrant families seeking asylum.  Every day, over 100 detained families are dropped off at these churches by US Immigration and Customs Enforcement officials.  Many immigrants have been given no instructions on where to go or how to find relatives living in the US.  Others are dropped off at bus stops, leaving them homeless and helpless in an unfamiliar country without money, cell phones, or information on where to go.
As the daughter of immigrants, I am privileged and honored to be part of this group of volunteers providing humanitarian assistance to these individuals and I recently wrote about this experience in an article published by the American Academy of Physician Assistants.  I am also thankful that these churches have opened their doors and provided humanitarian assistance by allowing us to establish volunteer-run free clinics for these vulnerable immigrant families.  Many of our medications are donated, but too often supplies run short for treating even the most common illnesses.  Common conditions we frequently treat are upper respiratory infections, fevers, otitis media, fungal infections, and wound care.  Because of the scarce medical resources, I have raised funds to help purchase medications and other medical supplies.  In addition to bringing awareness to the current humanitarian situation with asylum-seeking immigrants, I have used social media to recruit medical volunteers.  The largest challenges in this humanitarian relief effort are the political and social determinants that have further complicated their access to medical care and continuity of care. 

As a physician assistant, the combination of delivering health care to patients and conducting research to identify factors that lead to health disparities and find solutions for those disparities is the most fulfilling and gratifying aspect of my career and is a way to better serve my patients.  We live in a world where there are many impoverished communities that lack access to medical care.  As a practicing physician assistant, I want to continue devoting my time to assist those who are most in need, and I hope that more physician assistants will be inspired to conduct research and develop effective educational interventions for underserved communities.