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Lung Biology Center
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John R. Balmes, M.D.
University of California San Francisco
UCSF Box 0853
tel: 415-206-8953
fax: 415-206-8949
additional websites:

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. 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. In 2002, Dr. Balmes was appointed Professor of Environmental Health Sciences at the School of Public Health at UC Berkeley where he directs the Northern California Center for Occupational and Environmental Health and the Center for Environmental Public Health Tracking.

Research Interests

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 and fine particles. 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, and c) that ozone-induced inflammatory responses in both normal and asthmatic subjects attenuate with short-term exposures on consecutive days. We are currently using microarray and multiplex quantitative PCR techniques to characterize patterns of gene expression in our human model of ozone-induced acute airway inflammation. We are planning to study the effects of polymorphisms of various antioxidant enzymes on ozone-induced increases in inflammatory responses to local endobronchial allergen challenge.

The HEL is also investigating the acute effects of inhalational exposure to fine particles with several studies. We are currently studying the effects of exposure to particles, with and without ozone, on inflammatory responses of allergic asthmatic subjects. We are planning two other studies: one to assess whether asthmatic subjects have enhanced zinc oxide-induced neutrophil recruitment to the lungs; and a second to assess the airway inflammatory effects of exposure to diesel exhaust in both normal and asthmatic subjects.

Dr. Balmes is also collaborating with Dr. Ira Tager of UC, Berkeley on several epidemiological projects. The first is designed to compare the lung function of lifetime residents of the Los Angeles Basin to that of lifetime residents of the San Francisco Bay area in order to determine the effects of chronic exposure to ozone on lung structure/function. The acute lung function, inflammatory, and anti-oxidant responses to controlled exposure to ozone will be assessed in subgroups of both these populations. The second 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 450 asthmatic children (ages 6-10) will be followed closely over 4.5 years with serial measurements of lung function and asthma severity (symptoms, medication use) as well as serial assessment of both indoor and outdoor exposures. Another collaboration in the planning stage involves the chronic effects of early life exposure to biomass smoke among Mayan children in highland Guatemala.

Selected Publications

Scannell C, Chen LL, Aris RM, Tager I, Christian D, Ferrando R, Welch B, Kelly T, Balmes JR. Greater ozone-induced inflammatory responses in subjects with asthma. Am J Respir Crit Care Med 1996; 154:24-29. (abstract)

Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, Keogh J, Meyskens FL, Valanis B, Williams JH, Barnhart S, Hammar S. Effects of the combination of beta-carotene and vitamin A on lung cancer incidence, total mortality, and cardiovascular mortality in smokers and asbestos-exposed workers. New Engl J Med 1996; 334:1150-55.(abstract)/(full text)

Kunzli N, Lurman F, Segal M, Ngo L, Balmes J, Tager IB. Association between lifetime ambient ozone exposure and pulmonary function in college freshman -- results of a pilot study. Environ Res 1997; 72:8-23.(abstract)/ (full text)

Chuwers P, Barnhart S, Blanc P, Brodkin C, Cullen M, Kelly T, Keogh J, Omenn G, Williams J, Balmes JR. The protective effect of ? -carotene and retinol on ventilatory function in an asbestos-exposed cohort. Am J Respir Critical Care Med 1997; 155:1066-1071.(abstract)

Christian DL, Chen LL, Scannell CH, Ferrando RE, Welch BS, Balmes JR. Ozone-induced inflammation is attenuated with multi-day exposure. Am J Respir Crit Care Med 1998; 158:532-537.(abstract)/ (full text)

Forastiere F, Balmes J, Scarinci M, Tager IB. Occupation, asthma and chronic respiratory symptoms in a community sample of older women. Am J Respir Crit Care Med 1998; 157:1864-1870.(abstract)/ (full text)

Solomon C, Christian DL, Welch BS, Kleinman MT, Dunham E, Erle DJ, Balmes JR. Effects of multi-day exposure to nitrogen dioxide on airway inflammation. Eur Respir J 2000; 15:922-928.(abstract)

Criqui GI, Solomon C, Welch BS, Ferrando RE, Boushey HA, Balmes JR. Effects of azithromycin on ozone-induced airway neutrophilia and cytokine release. Eur Respir J 2000; 15:856-862.(abstract)

Renisch F, Harrison RJ, Cussler S, Athanasoulis M, Balmes J, Blanc P, Cone J. Physician reports of work-related asthma, 1993-1996. Am J Ind Med 2001;39:72-83.(abstract)

Zitter JN, Mazonson PD, Miller DP, Hulley SB, Balmes JR. Aircraft cabin air recirculation and symptoms of the common cold: a natural experiment. JAMA 2002;288:483-486.

Shusterman D, Balmes JR, Avila PC, Murphy MA, Matovinovic E. Chlorine inhalation produces nasal congestion without mast cell degranulation. Eur Respir J 2003; 21:652-657.

Jenkins BM, Mehlschau JJ, Williams RB, Solomon C, Balmes J, Kleinman M, Smith N. Rice straw smoke generation system for controlled human inhalation exposures. Aerosol Sci Technology 2003; 37:437-454.

Mortimer KM, Fallot A, Balmes JR, Tager IB. Evaluating the use of a portable spirometer in a study of pediatric asthma. Chest 2003; 123: 1899-1907.

Shusterman D, Murphy MA, Balmes J. Influence of age, gender, and allergy status on nasal reactivity to inhaled chlorine. Inhal Toxicol 2003; 15: 1179-1189.

Trupin L, Earnest G, San Pedro M, Balmes JR, Eisner MD, Yelin E, Katz PP, Blanc PD. The occupational burden of chronic obstructive pulmonary disease. Eur Respir J 2003; 22: 462-469.

Chen LL, Tager IB, Peden DB, Christian DL, Ferrando RE, Welch BS, Balmes JR. Effect of ozone exposure on airway responses to inhaled allergen in asthmatic subjects. Chest (in press).


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