Educational Background
Dr.P.H., Public Health, Harvard School of Public Health, 1989
M.Occ.H., Public Health, Harvard School of Public Health, 1985
MD., Medicine, Johns Hopkins University, 1980
B.A., Chemistry, University of Maryland, 1976
Scholarly Interests
My work focuses on respiratory health and aerobiology including endotoxin, asthma, and airborne infectious diseases.
Endotoxin and other Bioaerosols in Industrial Environments Using improved biological assay methods for endotoxin and GC-MS-MS based chemical methods for lipopolysaccharide we studied manufacturing workers exposed to complex mixtures including endotoxin. We described the presence of two distinct chronic effects associated with endotoxin exposure: asthma and emphysema. We also found that personal exposure to airborne endotoxin above 45 Endotoxin Units/m3 was associated with acute decrements in lung function over the working day, controlling for the presence of other respiratory irritants.
Endotoxin and other Bioaerosols at Home and in the Office Ongoing studies are examining whether endotoxin plays a role in respiratory disease at levels much lower than encountered in the industrial environments. We are studying whether endotoxin contributes to the onset of wheeze and asthma in two birth cohorts. We are also investigating whether endotoxin in homes can be shown to exacerbate the asthma of their parents and siblings. Other studies are examining whether the non-specific building related symptoms (sometime referred to as sick building syndrome) are associated with levels of gram-negative bacteria or endotoxin in office buildings. We are also using an innovative case-crossover design to determine whether patients treated for acute asthma at a Massachusetts HMO are allergic to materials in the ambient air collected at the time of their asthma exacerbation.
Adult-Onset and Occupational Asthma In an pilot epidemiologic study of new asthma patients identified over 3 months at a Massachusetts HMO, we found that asthma attributable to occupational exposures was more frequent than generally recognized. Few physicians asked patients about work-related exposures. But, when investigated 21% of patients with adult onset asthma had asthma attributable to their occupational exposures. This study introduced new methods for measuring the incidence of asthma and of occupational asthma. We are now using these methods in a larger and more definitive study of risk factors contributing to adult-onset asthma with particular emphsis on the population attributable risk and incidence of occupational asthma.
The Indoor Environment, Airborne Infection Transmission, and Biodefense We recently found that lower illness absence rates at a large employer were associated with increased outside air supply. We have developed a method for detection of respiratory infectious agents in air using RT-PCR analysis and have employed this in our study of office ventilation. We found that lower ventilation was associated with increased probability of detecting rhinovirus in office building air. We are currently working to extend this work to test whether air sanitation using upper room ultraviolet light or other disinfection methods can prevent spread of respiratory infections in schools. We are also testing the effectiveness of ultraviolet light as a means of disinfecting pox virus aerosols. This work will have important implications for constructing effective defenses against bioterrorism in the case of an attack using communicable respiratory infectious agents such as smallpox or genetically modified influenza.
Bio Sketch
Dr. Milton received his MD from Johns Hopkins University and his DrPH from Harvard University. He trained in medicine at Emory and Boston Universities and Occupational and Environmental Medicine at Harvard. He joined the Harvard School of Public Health Faculty in 1990 and was appointed Professor in University of Massachusetts Lowell’s School of Health and Environment in 2005. He teaches courses on aerobiology, toxicology and respiratory epidemiology. He is currently Adjunct Senior Lecturer on Occupational and Environmental Health at Harvard School of Public Health, Lecturer on Medicine at Harvard Medical School and Attending Physician at Brigham and Women’s Hospital.
Dr. Milton directs the Environmental Microbiology and Environmental Microbial Biomarkers Laboratories, engaged in NIH funded multidisciplinary investigations of the health effects of bioaersols. There are two major areas of research in Dr. Milton’s laboratory: 1) the relationship of asthma onset and exacerbation to exposure to allergens and microbial products and 2) prevention of airborne infection. Asthma research in the lab ranges from studies of high level occupational endotoxin exposures to the effects of low exposures in homes on development of allergy and asthma among infants. Work on mechanisms and prevention of airborne infection transmission ranges from productivity effects of rhinovirus colds on office workers and asthmatic children, to methods for preventing airborne communicable infection – particularly influenza and agents of biological warfare and terrorism.
Curriculum Vitae .pdf format
Aerobiology - Biomarkers Laboratory (Milton Lab)