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Milken Institute School of Public Health

 

Ruth Ann Etzel

Ruth Etzel

Ruth Ann Etzel

M.D., Ph.D.

Professorial Lecturer

Part-time Faculty

School: Milken Institute School of Public Health

Department: Environmental and Occupational Health

Contact:

Dr. Etzel is an internationally-known pediatrician and preventive medicine specialist.  She is the founding editor of Pediatric Environmental Health, an influential book that has helped thousands of doctors to better recognize, diagnose, treat and prevent illness in children from environmental pollution.  From 2009 to 2012 she led the World Health Organization’s activities to protect children from environmental hazards. She worked for 12 years at the Centers for Disease Control and Prevention where she founded and directed the Air Pollution and Respiratory Health Branch.  She conducted investigations of numerous epidemics, including outbreaks of sudden deaths in Sierra Leone due to parathion poisoning and of sudden deaths in Guatemala from paralytic shellfish poisoning.  She designed and oversaw studies that identified the cause of epidemic asthma in Barcelona and New Orleans, as well as investigations of the health effects of exposure to serious air pollution in Central and Eastern Europe and Mexico City.  She was sent to Kuwait immediately after the cessation of hostilities in 1991 to determine the health impact of the more than 750 oil well fires burning near Kuwait City. 

Notably, Dr. Etzel performed the first study to document that children with secondhand exposure to tobacco smoke had measurable exposure to nicotine.  Her pioneering work led to nationwide efforts to reduce indoor exposure to tobacco, including the ban on smoking in US airliners.  She discovered the link between exposure to water-damaged, moldy homes and fatal infant pulmonary hemorrhage, for which she received the Clinical Society Award from the U.S. Public Health Service Commissioned Officers Association.

In 2007 the U.S. EPA honored Dr. Etzel with the Children’s Environmental Health Champion Award for outstanding leadership in protecting children from environmental health risks. She received the Distinguished Service Medal from the U.S. Public Health Service, the Don C. Mackel Memorial Award from the CDC, and the prestigious Arthur S. Flemming Award.  She is a courageous leader in bringing environmental health risks to public attention and working collaboratively towards solutions.  For her persistence in speaking truth to power, she is known as an “inconvenient” pediatrician.

EXPERTISE: 

Children's Health

Environmental Health Policy

Epidemiology

Global Environmental Health

Native American Health

Population Health

Prevention

Climate Change

 

EDUCATION: 

Bachelor of Arts (Biology), University of Minnesota, 1976

Doctor of Medicine, University of Wisconsin, 1980

Doctor of Philosophy (Epidemiology), University of North Carolina School of Public Health, 1985

 

COMMUNITY SERVICE: 

Dr. Etzel is a Fellow of the Collegium Ramazzini, the American Academy of Pediatrics and the American College of Preventive Medicine. She is an Associate Editor of Environmental Health and Current Problems in Pediatrics and Adolescent Health Care and serves as a peer reviewer for numerous journals, including The Journal of Pediatrics, Pediatrics, Environmental Health Perspectives, and The Journal of the American Medical Association.

RESEARCH: 

Dr. Etzel has carried out many emergency epidemiologic investigations of critical environmental health problems in the United States as well as Guatemala, Guyana, Hungary, Kuwait, Mexico, Sierra Leone, and Uzbekistan. Her current research focuses on assessing the effects of exposures to indoor and outdoor air pollutants on the respiratory health of infants and children.

Awards

Herbert L. Needleman Scientist-Advocate Award, International Society for Children’s Health and the Environment, Mérida, Mexico, 2019

Research Integrity Award, International Society for Environmental Epidemiology, Utrecht, The Netherlands, 2019

Child Health Advocate Award, Children’s Environmental Health Network, Washington, D.C, 2019

Outstanding Achievement Award, American Academy of Pediatrics Section on Epidemiology, Public Health, and Evidence and Council on Community Pediatrics, New Orleans, Louisiana, 2019

Distinguished Service Medal, U.S. Public Health Service, “for continuous visionary leadership and outstanding accomplishments in achieving national public health objectives”, 2008

Children’s Environmental Health Champion Award, U.S. Environmental Protection Agency, for outstanding leadership in protecting children from environmental health risks, 2007

Arthur S. Flemming Award, Scientific Category, presented by the Washington, D.C. Jaycees to ten outstanding individuals in the Federal Government, 1991

Don C. Mackel Memorial Award, CDC, “for the oral EIS presentation that best exemplifies the effective utilization of a combined epidemiologic and laboratoryapproach to an investigation”, 1987

Phi Beta Kappa, University of Minnesota, 1976

PUBLICATIONS: 

Protecting Your Child’s Health: Expert Answers to Urgent Environmental Questions

  • Etzel RA, Balk SJ.  Protecting Your Child’s Health: Expert Answers to Urgent Environmental Questions. Itasca, IL: American Academy of Pediatrics, 2021.

Pediatric Environmental Health

  • Etzel RA. Pediatric Environmental Health. In Oxford Bibliographies in Public Health. Ed. David McQueen. New York: Oxford University Press, 2021.

Addressing climate change: Academic pediatricians’ personal and professional actions

  • Kemper KJ, Etzel RA. Addressing climate change: Academic pediatricians’ personal and professional actions. Complement Ther Med 2020; 50: 102386 doi: 10.1016/j.ctim.2020.102386.

Research about climate advocacy: Directions from a pilot survey of academic pediatricians

  • Kemper KJ, Etzel RA.  Research about climate advocacy: Directions from a pilot survey of academic pediatricians. Complement Ther Med 2020; 49: 102335 doi: 10.1016/j.ctim.2020.102335.

Is the environment associated with preterm birth? 

  • Etzel RA.  Is the environment associated with preterm birth?  JAMA Netw Open 2020 Apr; 3(4): e202239. doi: 10.1001/Jamanetworkopen.2020.2239.

Global Pediatric Pulmonology Alliance recommendation to strengthen prevention of pediatric seasonal influenza under COVID-19 pandemic

  • Shen KL, Namazova-Baranova L, Yang YH, Wong GWK, Rosenwasser LJ, Rodewald LE, Goh AEN, Kerem E, O'Callaghan C, Kinane TB, Elnazir B, Triasih R, Horne R, Chang AB, Buttery J, Etzel RA, Ouchi K, Hoey H, Singh V, Rivera GC, Li SS, Guan Y; Global Pediatric Pulmonology Alliance (GPPA) Council, Cao L, Zheng YJ, Feng LZ, Zhong W, Xie ZD, Xu BP, Lin RJ, Lu G, Qin Q, Zhu CM, Qian SY, Liu G, Zhao CS, Wei Z, Zhao YH; Global Pediatric Pulmonology Alliance Expert Panel on Infectious Diseases & COVID-19. Global Pediatric Pulmonology Alliance recommendation to strengthen prevention of pediatric seasonal influenza under COVID-19 pandemic. World J Pediatr. 2020 Oct;16(5): 433-437. doi: 10.1007/s12519-020-00389-7.

Pediatric environmental health: exposures and interactions

  • An I, Etzel RA.  Chapter 5: Pediatric environmental health: exposures and interactions. In: Information Resources in Toxicology, 5th Edition (ISBN: 978-0-12-813724-6). Editor: Wexler P. London: Academic Press, 2020, pages 165-73.

Impact of extreme weather events on Sub-Saharan African child and adolescent mental health: A protocol for a systematic review

  • Rother H-A, Etzel RA, Shelton M, Paulson JA, Hayward RA, Theron LC. Impact of extreme weather events on Sub-Saharan African child and adolescent mental health:A protocol for a systematic review. Atmosphere 2020, 11, 493; doi:10.3390/atmos11050493

The special vulnerability of children

  • Etzel RA.  The special vulnerability of children.  Int J Hyg Environ Health 2020; 227: 113516.  doi.org/10.1016/j.ijheh.2020.113516

The International Society for Children's Health and the Environment commits to reduce its carbon footprint to safeguard children's health 

Open letter by Epidemic Intelligence Service Officers past and present - in support of CDC 

Benefits of cooperation among large-scale cohort studies and human biomonitoring projects in environmental health research: An exercise in blood lead analysis of the Environment and Child Health International Birth Cohort Group

Pediatric Environmental Health, 4th Edition

  • American Academy of Pediatrics Council on Environmental Health.  Pediatric Environmental Health, 4th Edition. Etzel RA, editor. Itasca, IL: American Academy of Pediatrics, 2019.

Global Health Research Competencies

  • Etzel RA.  Chapter 8 Global Health Research Competencies.  In: Principles of Global Child Health: Education and Research.  Editors: Laraque-Arena D and Staton BF.  Itasca, IL: American Academy of Pediatrics, 2019, pages 121-32.

Co-exposure to environmental endocrine disruptors in the US population

  • Chen L, Luo K, Etzel R, Zhang X, Tian Y, Zhang J. Co-exposure to environmental endocrine disruptors in the US population. Environ Sci Pollut Res Int. 2019 Jan 21. doi: 10.1007/s11356-018-04105-x.

Timescales of developmental toxicity impacting on research and needs for intervention

  • Grandjean P, Abdennebi-Najar L, Barouki R, Cranor CF, Etzel RA, Gee D, Heindel JJ, Hougaard KS, Hunt P, Nawrot TS, Prins GS, Ritz B, Soffritti M, Sunyer J, Weihe P. Timescales of developmental toxicity impacting on research and needs for intervention. Basic Clin Pharmacol Toxicol. 2018 Nov 2. doi: 10.1111/bcpt.13162.

Women physicians among authors of perspective-type articles published in high-impact pediatric journals: You haven’t come a long way, baby

  • Etzel RA.  Women physicians among authors of perspective-type articles published in high-impact pediatric journals: You haven’t come a long way, baby.  JAMA Network Open 2018;1(3): e180899. doi:10.1001/jamanetworkopen.2018.0899

Flooding: what is the impact on pregnancy and child health? 

  • Mallett LH, Etzel RA.  Flooding: what is the impact on pregnancy and child health?  Disasters 2018;42(3): 432-458. doi: 10.1111/disa.12256.

Two decades of enhancing children’s environmental health protection at the U.S. Environmental Protection Agency 

  • Firestone M, Berger M, Foos B, Etzel R.  Two decades of enhancing children’s environmental health protection at the U.S. Environmental Protection Agency.  Environ Health Perspect 2016;124: A214-8.

Children's environmental health: The role of primordial prevention

Renewing the Federal commitment to advance children's health: The President's Task Force on Environmental Health Risks and Safety Risks to Children

Environmental Issues

  • Etzel RA, Bhave SY.  Environmental Issues.  Chapter 7.3 In:  Bhave’s Textbook of Adolescent Medicine.  Editor: Bhave SY, Menon PSN, Parthasarathy A, Greydanus DE.  Delhi: Peepee Publishers, 2016, pp. 277-282.

Environmental Nephrotoxins

  • Ding J, Etzel RA.  Environmental Nephrotoxins.  Chapter 74 In: Pediatric Kidney Disease, 2nd Edition.  Editors: Geary DF & Schaefer F.  NY: Springer-Verlag, 2016, pp. 1975-1992.

Environmental Hazards

  • Etzel RA.  Chapter on Environmental Hazards.  In:  Textbook of Global Child Health, 2nd edition.  Kamat DM and Fischer PR (Eds.) Elk Grove Village, IL: American Academy of Pediatrics, 2016, pp. 137-152.

Clinical Practice Guideline: Brief resolved unexplained events (formerly apparent life-threatening events) and evaluation of lower risk infants 

  • Tieder JS, Bonkowsky JL, Etzel RA, and the American Academy of Pediatrics Subcommittee on Apparent Life Threatening Events.  Clinical Practice Guideline: Brief resolved unexplained events (formerly apparent life-threatening events) and evaluation of lower risk infants.  Pediatrics. 2016;137(5): e20160590.

Life-long implications of developmental exposure to environmental stressors: new perspectives

  • Grandjean P, Barouki R, Bellinger D, Castelyn L, Chadwick LH, Cordier S, Etzel RA, Gray KA, Ha E-H, Junier C, Karagas M, Kawamoto T, Lawrence BP, Perera F, Prins G, Puga A, Rosenfield CS, Sherr D, Sly P, Suk W, Sun Q, Toppari J, van den Hazel P, Walker CL, Heindel JJ.  Life-long implications of developmental exposure to environmental stressors: new perspectives.  Endocrinology 2015;156(10): 3408-15.

Environmental hazards that matter for children

  • Etzel RA.  Environmental hazards that matter for children.  Hong Kong Journal of Paediatrics 2015;20: 86-94.

Harmonizing biomarker measurements in longitudinal studies of children’s health and the environment 

  • Etzel R, Charles M-A, Dellarco M, Gajeski K, Jöckel K-H, Hirschfeld S, Kamijima M, Kawamoto T, Kolossa-Gehring M, Nakayama S, Schmidt B, Tian Y, Zaros C, Zhang J.  Harmonizing biomarker measurements in longitudinal studies of children’s health and the environment.  Biomonitoring 2014; 1: 50-62.

Faculty competencies for global health

  • Etzel R, Kurbasic M, Staton D, Vaucher Y, Bortolussi R, Anspacher M, Howard C, John C, Russ C, Schubert C, St. Clair N, Abdulrahman E, Arora T, Batra M, Behrmann A, Breslin K, Brooks M, Butteris S, Callender M, Chan K, Chapman J, Cohn K, Dudani R, Gladding S, Harisiades J, Hassai A, Kern L, Kihara R, Kraft C, Laraque D, Leib S, Lofrumento M, Lowenthal E, Marshall R, Moneymaker C, Muelenaer A, Niescierenko M, O’Callahan C, Olusanya B, Pannaraj P, Pitt M, Rosser L, Rushton F, Schwart K , Sherman A, Slusher T, Steenhoff A, Suchdev P, Summers A, Vesga E, Warrick S, Zipursky A. Faculty competencies for global health. Reston, VA: Academic Pediatric Association, 2014.

Reducing malnutrition: time to consider potential links between stunting and mycotoxin exposure?

Quitting tobacco: let’s keep talking to parents

  • Balk SJ, Etzel RA.  Quitting tobacco: let’s keep talking to parents.  Pediatrics 2014;134: 1028-29.

Early-life prevention of non-communicable diseases

  • Balbus JM, Barouki R, Birnbaum LS, Etzel RA, Gluckman PG, Grandjean P, Hancock C, Hanson MA, Heindel JJ, Hoffman K, Jensen GJ, Keeling A, Neira M, Rabadán-Diehl C, Ralston J, Tang K-C. Early-life prevention of non-communicable diseases. Lancet 2013; 381 (9860): 3-4.

Primary care pediatrics and public health: Meeting the needs of today's children

Environmental Hazards

  • Etzel RA. Chapter 7: Environmental Hazards. In: Textbook of Global Child Health. Kamat DM and Fischer PR (Eds.) Elk Grove Village, IL: American Academy of Pediatrics, 2012, pages 153-169.

Household air pollution: A cause of lung disease in children

  • Etzel RA. Household air pollution: a cause of lung disease in children. In: Living conditions: The influence on young children's health. Early Childhood Matters no. 118, The Hague, Netherlands: Bernard van Leer Foundation, Belgium, July 2012.

And how are the children?

  • Etzel RA. And how are the children? Academic Pediatrics 2012;12:161-162.

Self-reported asthma among American Indian and Alaska Native people in Alaska

  • Orell LJ, Ferucci ED, Lanier AP, Etzel RA. Self-reported asthma among American Indian and Alaska Native people in Alaska.  J Health Care Poor Underserved, 2011; 22(4): 1264-78.

NTP-CERHR expert panel report on the developmental toxicity of soy infant formula

Environmental Pediatrics

  • Etzel RA. Chapter 17: Environmental Pediatrics. In: Rudolph's Pediatrics, 22nd Ed. Rudolph CD, Rudolph AM, First LR, Gershon AA (Eds.) McGraw-Hill, 2011.

Statement of Principles: APA-Industry Relationship 

  • Laraque D, Etzel R and Academic Pediatric Association Public Policy and Advocacy Committee. Statement of Principles: APA-Industry Relationship. Academic Pediatrics 2011;11: 355-356.

Pediatric Environmental Health 3rd Edition

  • American Academy of Pediatrics Council on Environmental Health. Pediatric Environmental Health, 3rd Edition. Etzel RA, editor. Elk Grove Village, IL: American Academy of Pediatrics, 2011.