- My early publications focused on antigen exposure characterization and outbreak investigations of hypersensitivity pneumonitis. I developed and led a multi-disciplinary program involving physicians, industrial hygienists, epidemiologists and microbiologists. I described the first reported outbreak of “lifeguard lung”, and was a leader in creating the program in noninfectious granulomatous pneumonitis at National Jewish Health. I was co-investigator on an NIH-funded multi-center study investigating the causes and describing clinical phenotypes of sarcoidosis. I have an on-going interest in antigen recognition and abatement in patients with hypersensitivity pneumonitis.
- Since 2003, I have had federal funding for programs focused on cardiopulmonary diseases in western miners and historic uranium industry workers. As Principal Investigator and Medical Director of the Miners Clinic, I have developed a program of clinical care and research that has led to a number of scientific publications. Our recent work implicates exposure to respirable silica and silicates in increased prevalence and severity of Coal Worker’s Pneumoconiosis and progressive massive fibrosis (PMF), as well as newly recognized accelerated silicosis in stone fabricators. Our team helped establish a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry to investigate differences in workplace exposure and clinical findings in engineered stone workers. As part of a larger Pneumoconiosis coalition, we recently received funding from the Alpha Foundation for Improving Mine Safety & Health to explore risk factors and prevalence of mental illness in U.S. coal miners.
- In 2009, I created the Colorado-based clinical research program on deployment-related lung diseases. I developed collaborations with military and academic scientists and physicians including in the Department of Defense (DOD), the Veterans Administration, the U.S. Geological Survey, and laboratory-based scientists at National Jewish Health. I was principal investigator on a DOD-funded study to examine lung histologic profiles of symptomatic Iraq and Afghanistan deployers. In 2016, our multi-disciplinary group of investigators obtained DOD funding for a 5-year multi-project study to explore mechanisms and treatment of deployment-related epithelial lung injury. I am a Project Lead/PI on “Exposure Characterization and Identification of Noninvasive Methods for Diagnosis of Deployment-Related Lung Disease” that expands our research on deployment exposure and disease characterization, Lung Clearance Index testing, and quantitative chest CT analysis. I am co-Principal Investigator on a clinical trial exploring the use of L-citrulline supplementation in improving deployment-related asthma. I served on the National Academy of Sciences, Engineering and Medicine (NASEM) committees on The Assessment of the Dept. of Veterans Affairs Airborne Hazards and Open Burn Pit Registry and the Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations.