Seeing Red
Beachcomber tracks marine toxins in Florida.
Epidemiologist Lora Fleming ’78, M.D.-M.P.H. ’84, tackles breathing, cancer, and unexpected days at the beach. At the office, she directs research on a database of 3 million cancer cases, or culls morbidity factors among blue-collar workers across the country. Other days she may find herself swabbing the noses of asthmatics exposed to Florida red-tide toxins. Not too long ago, she and a colleague spent a morning chasing after dogs that had defecated on a Miami beach. “That was part of the recreational microbes study—or, as we call it, the ‘poop in the water’ study,” she explains. Even trickier than corralling the canines was “figuring out how to get the damn seabirds to go on the plastic we had laid out for them. Then some bird guy called us from Mississippi and said, ‘I have two words for you: “Cheese Doodles.”’ They eat the doodles and poop, apparently.”
Photograph by Christian Howard / Rosenstiel School of Marine and Atmospheric Sciences at the University of Miami
Lora Fleming
Fleming’s aplomb sometimes shields the fact that she is among those at the top of the somewhat esoteric field of studying oceans and human health. Collecting the specimens contributed to a larger study on microbes in ocean waters. “People have done this kind of work for chlorinated pools in the past,” she says, “but this is the first time that such a study has been done for a marine environment in subtropical and tropical areas. We want to know: what are the inputs when you do not have an obvious sewage outflow? The big one is through runoff, but there are also inputs from birds and other wildlife, domestic animals—and humans. The hypothesis is that people who go into the water will have a higher risk of reporting a range of diseases, and that that will correlate with the levels of microbes we find in the water near their mouths.”
Growing up in Boston, Fleming spent summers on the North Atlantic coast, sailing, swimming, and collecting clams and mussels from the local beach for dinner. She no longer eats raw shellfish—and even tries to avoid it when cooked—because of potential bacterial and viral contamination. But she remains enthralled by everything oceanic.
Miami became home in 1989 when she and her husband, marine biologist Mauricio Ortiz, moved there for his doctoral studies. (He now monitors fish populations for the federal government.) The region has proved a natural fit. On family vacations, they often sail the Caribbean, where Ortiz and their daughter, an aspiring oceanographer, scuba dive while Fleming skims the surface in her snorkel gear. “They make fun of me because I’m not a diver: there’s a big hierarchy there,” Fleming says. “I love snorkeling because it’s low-tech—put the mask on and get in the water.”
At work, her joint appointment at the University of Miami’s Miller School of Medicine and Rosenstiel School of Marine and Atmospheric Science necessitates wearing several professional caps. She is the medical director of Florida’s Cancer Data System, the second-largest registry behind California’s. She also co-directs research on occupational health, funded by the National Institute of occupational Safety and Health, using information that has been collected since 1957 through the National Health Interview Survey. The survey uses data from random samplings of citizens each year to track trends in illness and disability and to gauge progress on national health objectives. “All I can say is: it’s great to be white and male and professional,” she remarks. “The socioeconomic influences on health are just huge.”
Fleming has a keen interest in children’s health as well; she completed her medical residency in family medicine before earning a doctorate in epidemiology from Yale in 1997. A small pilot study that she was involved in examined arsenic exposure rates for children using wooden playground equipment preserved with copper, chromate, and arsenic (CCA), a common rot-retardant. Results showed that children “do get arsenic on their hands, which travels to their mouths and into their bodies,” she says. “This work needs to be followed up because children continue to be exposed.” CCA-treated wood is now prohibited for new residential use (although existing wood does not have to be removed), but it is still used widely in marine environments, where it affects ocean life.
At the university, Fleming also co-directs one of only four oceans-and-human-health research centers in the country funded by the National Science Foundation and the National Institute of Environmental Health Sciences. Established in 2004, the center helps promote research, devise curricular material for schools, and develop public information. “Until [the center] was funded, it was unlikely that researchers from various parts of oceanography and public health worked together,” she notes.
Such cooperation has been essential to Fleming’s groundbreaking work on how humans are affected by Florida red tide. These groupings of harmful algal blooms (HABs), first documented scientifically in Florida in 1947, are composed of single-celled organisms called Karenia brevis. “Red tides happen throughout the world,” Fleming explains. “This particular organism likes to live in the Gulf of Mexico. Other organisms cause different red tides elsewhere.” Karenia brevis, which is relatively fragile, breaks apart easily in the surf, releasing brevetoxins into the water and often into the air; these have been blamed for killing thousands of fish, as well as numbers of manatees and dolphins, and for causing human illness.
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