Howard Hu, MD, MPH, ScD

Howard Hu, MD, MPH, ScD, is Professor of Preventive Medicine (tenured) in the Department of Population and Public Health Sciences, Keck School of Medicine, at the University of Southern California. From July 1, 2020-June 30, 2024, he was the Flora L. Thornton Chair of the Department. Dr. Hu is a physician-scientist, internist and preventive medicine specialist, with a doctoral degree in epidemiology. Prior to coming to USC, he had been Professor of Occupational & Environmental Medicine (tenured), Founding Director of the NIH/NIEHS Center for Children’s Environmental Health, Director of the Occupational Medicine Residency at the Harvard School of Public Health and Associate Physician in the Brigham & Women’s Hospital in Boston (1988- 2006); the NSF International Endowed Chair of the Department of Environmental Health Sciences, Professor of Environmental Health, Epidemiology and Medicine (tenured), Founding Director of the NIH/NIEHS Environmental Health Core Sciences Center, and Associate Physician at the University of Michigan and University of Michigan Health System (2006-2012); and Professor of Environmental Health, Epidemiology, Global Health, and Medicine (tenured) and the Founding Dean of the Dalla Lana School of Public Health, University of Toronto (2012-2018). In 2018-2020, Dr. Hu was a Visiting scholar and then an Affiliate Professor at the University of Washington School of Public Health.

Since 1990, Dr. Hu has led multi-institutional and international teams of scientists, students and fellows devoted to investigating the environmental, nutritional, social, psychosocial, genetic and epigenetic determinants of chronic disease and impaired child development in birth cohort and aging cohort studies in the U.S., Mexico, India, China, and elsewhere around the world. His team’s work has generated over 400 peer-reviewed publications and won a number of awards. In 2016, Dr. Hu was elected to the Fellowship in the Canadian Academy of Health Sciences.

Dr. Hu currently continues his work co-leading NIH-funded environmental birth cohort research through the Early Life Exposures in Mexico to Environmental Toxicants project (ELEMENT); co-leads the USC Sustainability & Healthcare initiative; and co-leads the Global Burden of Disease Pollution & Climate initiative. The latter aims to improve understanding of pollution’s “footprint” on the global burden of disease.

In 1999-2000, Dr. Hu was a Senior Faculty Fulbright Scholar in India. He served on the Board of Directors and on four fact-finding missions for Physicians for Human Rights (Nobel Peace Prize co-winner, 1997); on the Board of Population and Public Health Practice of the Institute of Medicine of the National Academy of Sciences; on the Board of Environmental Studies and Toxicology of the National Research Council; on the External Advisory Council of the U.S. National Institute for Environmental Health Sciences; and as the Chair of the Research Commission for the International Physicians for the Prevention of Nuclear War (Nobel Peace Prize, 1985). In the latter capacity, he and colleagues published “Nuclear Wastelands”, which was nominated for the U.S. National Book Award in 1996. Dr. Hu currently chairs the Scientific Advisory Board of the Marilyn Brachman Hoffman Foundation, co-Chairs the Research Council of the Public Health Foundation of India, serves on the Board of Pure Earth, and serves on the Advisory Council of Physicians for Human Rights.

• Danon Institute: First Prize, Infant Nutrition Research, 1998
   – 1998
• NIH/National Institute Environemntal Health Sciences: Progress & Achievement Award (Research), 1999
   – 1999
• US Department of State: Senior Faculty Fulbright, 2000
   – 2001
• American College of Occupational and Environmental Medicine: Adolph G. Kammer Merit in Authorship, 2005
   – 2005
• OEM Residency, Harvard School of Public Health: Teacher of the Year, 2005
   – 2006
• New England College of Occupational and Environmental Medicine: Harriett Hardy Award, 2006
   – 2006
• American College for the Advancement of Medicine: Linus Pauling Award for Lifetime Achievements, 2009
   – 2009
• American Public Health Association: Award for Excellence (Research), 2011
   – 2011
• International Society for Environmental Epidemiology: John R. Goldsmith Award for Outstanding Contributions to Environmental Epidemiology, 2015
   – 2015
• Canadian Academy of Health Sciences: Election to Fellowship, 2016
   – 2016

• Albert Einstein College of Medicine, Bronx, NY — MD — 06/1982 — Medicine
• Harvard School of Public Health, Boston, MA — MPH — 06/1982 — Occupational Health
• Harvard School of Public Health, Boston, MA — MS — 06/1986 — Epidemiology
• Harvard School of Public Health, Boston, MA — ScD — 06/1990 — Epidemiology
• Harvard School of Public Health, Boston, MA — 06/1987 — Occupational/Environmental Medicine

• environmental epidemiology, broad interests

• Prenatal fluoride exposure and motor development among infants in Los Angeles, California. Environ Res. 2026 Jul 09; 306(Pt 2):125235.. View in PubMed
• Associations of Estrogen Receptor 1 and Vitamin D Receptor Gene Polymorphisms with Bone Resorption During Pregnancy and Early Postpartum in a Mexican Cohort. Arch Med Res. 2026 Jul; 57(5):103424.. View in PubMed
• Racial and ethnic differences in the impact of air pollution on the risk of Alzheimer’s disease and related dementias in the Multiethnic Cohort Study. Environ Int. 2026 Mar; 209:110169.. View in PubMed
• Prenatal fluoride exposure and autistic behaviors in preschool-aged children: the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort study. Environ Health. 2025 Nov 11; 24(1):87.. View in PubMed
• International fluoride symposium: effects of fluoride on human health and its mechanisms of action – a meeting report. BMC Proc. 2025 Sep 29; 19(Suppl 26):28.. View in PubMed
• Lead exposure and antisocial behavior: A systematic review of human and animal evidence. Environ Int. 2025 Nov; 205:109786.. View in PubMed
• Fluoride, Teeth, and Developing Brains: Dental Health in Tension With Environmental Health, Millions Affected. Am J Public Health. 2025 Jul; 115(7):1022-1024.. View in PubMed
• A review of lead exposure source attributional studies. Sci Total Environ. 2025 Aug 15; 990:179838.. View in PubMed
• Promoting More Equitable Global Health Research, Education, and Community Partnerships: The Efforts of One US‑Based Academic Institution. Ann Glob Health. 2025; 91(1):31.. View in PubMed
• Influence of Overweight and Obesity on Bone Remodeling during Pregnancy. Res Sq. 2025 Jun 02.. View in PubMed
• Dietary Fluoride Exposure During Early Childhood and Its Association with Dental Fluorosis in a Sample of Mexican Adolescents. Int J Environ Res Public Health. 2025 04 26; 22(5).. View in PubMed
• Health Risks and Benefits of Fluoride Exposure During Pregnancy and Infancy. Annu Rev Public Health. 2025 04; 46(1):253-274.. View in PubMed
• Cumulative population blood lead levels. BMJ Glob Health. 2025 Mar 26; 10(3).. View in PubMed
• Urinary Fluoride Levels Among Youth in the National Health and Nutrition Examination Survey (NHANES) 2015-2016: Potential Differences According to Race. Nutrients. 2025 Jan 16; 17(2).. View in PubMed
• Change in depression and anxiety symptoms among university students, staff, and faculty during the COVID-19 pandemic: Trojan pandemic response initiative. J Am Coll Health. 2025 04; 73(4):1787-1797.. View in PubMed
• The effect of chelation on bone Pb stores in Pb poisoned children. J Expo Sci Environ Epidemiol. 2025 Sep; 35(5):709-714.. View in PubMed
• Fluoride content in table salt from the Element Project in Mexico City. Salud Publica Mex. 2024 Nov 27; 67(1 (ene-feb).. View in PubMed
• Removing lead from the global economy. Lancet Planet Health. 2024 11; 8(11):e966-e972.. View in PubMed
• COVID-19 Is a Coronary Artery Disease Risk Equivalent and Exhibits a Genetic Interaction With ABO Blood Type. Arterioscler Thromb Vasc Biol. 2024 11; 44(11):2321-2333.. View in PubMed
• Performance of the Social Responsiveness Scale-2 for the Assessment of Autistic Behaviors in a Sample of Canadian Preschool-Aged Children. J Autism Dev Disord. 2025 Nov; 55(11):4068-4080.. View in PubMed
• Structured expert judgement approach of the health impact of various chemicals and classes of chemicals. PLoS One. 2024; 19(6):e0298504.. View in PubMed
• Environmental pollutant risk factors for worse COVID-19 related clinical outcomes in predominately hispanic and latino populations. Environ Res. 2024 07 01; 252(Pt 4):119072.. View in PubMed
• Maternal Urinary Fluoride and Child Neurobehavior at Age 36 Months. JAMA Netw Open. 2024 05 01; 7(5):e2411987.. View in PubMed
• Do we underestimate risk of cardiovascular mortality due to lead exposure? Sci Total Environ. 2024 May 01; 923:171511. Park SK, Wang X, Lee S, Hu H . . View in PubMed
• Dose dependence of prenatal fluoride exposure associations with cognitive performance at school age in three prospective studies. Eur J Public Health. 2024 02 05; 34(1):143-149.. View in PubMed
• Nirmatrelvir-ritonavir (Paxlovid) Access, Use, and Eligibility Among Adults with COVID-19 in Los Angeles County: The LA Pandemic Surveillance Cohort Study. J Gen Intern Med. 2024 05; 39(6):1081-1083.. View in PubMed
• Prenatal and childhood lead exposure is prospectively associated with biological markers of aging in adolescence. Sci Total Environ. 2024 Feb 25; 913:169757.. View in PubMed
• Predicting the Climate Impact of Healthcare Facilities Using Gradient Boosting Machines. Clean Environ Syst. 2024 Mar; 12.. View in PubMed
• Association between levels of receptor binding domain antibodies of SARS-CoV-2, receipt of booster and risk of breakthrough infections: LA pandemic surveillance cohort study. Sci Rep. 2023 11 25; 13(1):20761.. View in PubMed
• Urinary fluoride levels and metal co-exposures among pregnant women in Los Angeles, California. Environ Health. 2023 10 26; 22(1):74.. View in PubMed
• Characteristics associated with attitudes and behaviors towards mask wearing during the COVID-19 pandemic: The Trojan Pandemic Response Initiative. BMC Public Health. 2023 10 11; 23(1):1968.. View in PubMed
• Lasting Adverse Effects of Low-Level Lead Exposure on Cognition and Heritable Susceptibilities. JAMA Netw Open. 2023 10 02; 6(10):e2339446.. View in PubMed
• Invited Perspective: An Argument for Changing the Reporting Units for Lead in Blood. Environ Health Perspect. 2023 09; 131(9):91303.. View in PubMed
• Early Lead Exposure Associated with Molar Hypomineralization. Pediatr Dent. 2023 Sep 15; 45(5):427-433.. View in PubMed
• What Long COVID Prevention Strategies Suggest About Its Pathophysiology. Open Forum Infect Dis. 2023 Oct; 10(10):ofad466.. View in PubMed
• Altered Tumor Necrosis Factor Response in Neurologic Postacute SARS-CoV-2 Syndrome. J Interferon Cytokine Res. 2023 07; 43(7):307-313.. View in PubMed
• SARS-CoV-2 viral variants can rapidly be identified for clinical decision making and population surveillance using a high-throughput digital droplet PCR assay. Sci Rep. 2023 05 10; 13(1):7612.. View in PubMed
• Association of environmental lead toxicity and hematologic outcomes in patients with advanced kidney disease. Nephrol Dial Transplant. 2023 05 04; 38(5):1337-1339.. View in PubMed
• Trust in science and scientists among university students, staff, and faculty of a large, diverse university in Los Angeles during the COVID-19 pandemic, the Trojan Pandemic Response Initiative. BMC Public Health. 2023 03 30; 23(1):601.. View in PubMed
• Surveillance of Severe Acute Respiratory Syndrome Coronavirus 2 and Variants Using Digital Droplet Polymerase Chain Reaction at a Large University and Healthcare System in California. Open Forum Infect Dis. 2023 Apr; 10(4):ofad147.. View in PubMed
• Quantification of Severe Acute Respiratory Syndrome Coronavirus 2 Binding Antibody Levels To Assess Infection and Vaccine-Induced Immunity Using WHO Standards. Microbiol Spectr. 2023 02 14; 11(1):e0370922.. View in PubMed
• Correlates of COVID-19 vaccination status among college students. J Am Coll Health. 2024 Dec; 72(9):3136-3138.. View in PubMed
• Predicting cumulative lead (Pb) exposure using the Super Learner algorithm. Chemosphere. 2023 Jan; 311(Pt 2):137125.. View in PubMed
• Communities, Mistrust, and Implementation: Addressing a Large Gap in the National Strategy for COVID-19 and Future Pandemics. Am J Public Health. 2022 12; 112(12):1713-1715.. View in PubMed
• Early life exposure to lead and its association with parent-reported aggression and conduct problems during childhood and adolescence. Neurotoxicology. 2022 12; 93:265-271.. View in PubMed
• Mortality Associated with Ambient PM2.5 Exposure in India: Results from the Million Death Study. Environ Health Perspect. 2022 09; 130(9):97004.. View in PubMed
• Lead exposure and antisocial behavior: A systematic review protocol. Environ Int. 2022 Oct; 168:107438.. View in PubMed
• COVID-19 booster vaccine attitudes and behaviors among university students and staff in the United States: The USC Trojan pandemic research Initiative. Prev Med Rep. 2022 Aug; 28:101866.. View in PubMed
• Role of renal function in the association of drinking water fluoride and plasma fluoride among adolescents in the United States: NHANES, 2013-2016. Environ Res. 2022 10; 213:113603.. View in PubMed
• Maternal urinary fluoride during pregnancy and birth weight and length: Results from ELEMENT cohort study. Sci Total Environ. 2022 Sep 10; 838(Pt 3):156459.. View in PubMed
• Factors associated with parents’ willingness to vaccinate their children against COVID-19: The LA pandemic surveillance cohort study. AIMS Public Health. 2022; 9(3):482-489.. View in PubMed
• Pollution and health: a progress update. Lancet Planet Health. 2022 06; 6(6):e535-e547.. View in PubMed
• Susceptibility to Environmental Heavy Metal Toxicity among Americans with Kidney Disease. Kidney360. 2022 07 28; 3(7):1191-1196.. View in PubMed
• Characteristics associated with COVID-19 vaccination status among staff and faculty of a large, diverse University in Los Angeles: The Trojan Pandemic Response Initiative. Prev Med Rep. 2022 Jun; 27:101802.. View in PubMed
• Domain-specific effects of prenatal fluoride exposure on child IQ at 4, 5, and 6-12 years in the ELEMENT cohort. Environ Res. 2022 08; 211:112993.. View in PubMed
• Did prioritizing essential workers help to achieve racial/ethnic equity in early COVID-19 vaccine distribution? The LA pandemic surveillance cohort study. Am J Ind Med. 2022 04; 65(4):231-241.. View in PubMed
• Serum antioxidant status and mortality from influenza and pneumonia in US adults. Public Health Nutr. 2022 Dec; 25(12):3466-3475.. View in PubMed
• Seroprevalence of Antibodies Specific to Receptor Binding Domain of SARS-CoV-2 and Vaccination Coverage Among Adults in Los Angeles County, April 2021: The LA Pandemic Surveillance Cohort Study. JAMA Netw Open. 2022 01 04; 5(1):e2144258.. View in PubMed
• All lead exposures matter – Authors’ reply. Lancet Planet Health. 2021 12; 5(12):e860.. View in PubMed
• In Utero Exposure to Mercury Is Associated With Increased Susceptibility to Liver Injury and Inflammation in Childhood. Hepatology. 2021 09; 74(3):1546-1559.. View in PubMed
• Prenatal maternal pesticide exposure in relation to sleep health of offspring during adolescence. Environ Res. 2022 03; 204(Pt A):111977.. View in PubMed
• Associations of exposure to cadmium, antimony, lead and their mixture with gestational thyroid homeostasis. Environ Pollut. 2021 Nov 15; 289:117905.. View in PubMed
• Dietary Influences on Urinary Fluoride over the Course of Pregnancy and at One-Year Postpartum. Biol Trace Elem Res. 2022 Apr; 200(4):1568-1579.. View in PubMed
• Prenatal Lead (Pb) Exposure and Peripheral Blood DNA Methylation (5mC) and Hydroxymethylation (5hmC) in Mexican Adolescents from the ELEMENT Birth Cohort. Environ Health Perspect. 2021 06; 129(6):67002.. View in PubMed
• DNA methylation at birth potentially mediates the association between prenatal lead (Pb) exposure and infant neurodevelopmental outcomes. Environ Epigenet. 2021; 7(1):dvab005.. View in PubMed
• A Benchmark Dose Analysis for Maternal Pregnancy Urine-Fluoride and IQ in Children. Risk Anal. 2022 03; 42(3):439-449.. View in PubMed
• Response to “Comment on ‘Environmental Cadmium and Mortality from Influenza and Pneumonia in U.S. Adults'”. Environ Health Perspect. 2021 04; 129(4):48004.. View in PubMed
• Association between cumulative childhood blood lead exposure and hepatic steatosis in young Mexican adults. Environ Res. 2021 05; 196:110980.. View in PubMed
• Blood lead levels in low-income and middle-income countries: a systematic review. Lancet Planet Health. 2021 03; 5(3):e145-e153.. View in PubMed
• Dietary fluoride intake over the course of pregnancy in Mexican women. Public Health Nutr. 2021 06; 24(9):2388-2396.. View in PubMed
• Association of Dietary Fluoride Intake and Diet Variables with Dental Caries in Adolescents from the ELEMENT Cohort Study. Caries Res. 2021; 55(2):88-98.. View in PubMed
• Increasing the Impact of Environmental Epidemiology in the Global Burden of Disease Project. Epidemiology. 2021 01; 32(1):1-5.. View in PubMed
• Environmental Cadmium and Mortality from Influenza and Pneumonia in U.S. Adults. Environ Health Perspect. 2020 12; 128(12):127004.. View in PubMed
• A Benchmark Dose Analysis for Maternal Pregnancy Urine-Fluoride and IQ in Children. medRxiv. 2020 Nov 04.. View in PubMed
• Blood levels of lead and dental caries in permanent teeth. J Public Health Dent. 2020 09; 80(4):297-303.. View in PubMed
• Trimester-Specific Associations of Prenatal Lead Exposure With Infant Cord Blood DNA Methylation at Birth. Epigenet Insights. 2020; 13:2516865720938669.. View in PubMed
• Estimating the causal effect of prenatal lead exposure on prepulse inhibition deficits in children and adolescents. Neurotoxicology. 2020 05; 78:116-126.. View in PubMed
• From Air Pollution to the Anthropocene and Planetary Health. Implications for Clinicians, Researchers, and Society. Ann Am Thorac Soc. 2020 02; 17(2):165-168.. View in PubMed
• Heavy Metals Exposure and Alzheimer’s Disease and Related Dementias. J Alzheimers Dis. 2020; 76(4):1215-1242.. View in PubMed
• Prenatal Lead Exposure, Type 2 Diabetes, and Cardiometabolic Risk Factors in Mexican Children at Age 10-18 Years. J Clin Endocrinol Metab. 2020 01 01; 105(1).. View in PubMed
• Effect of Dietary Sodium and Potassium Intake on the Mobilization of Bone Lead among Middle-Aged and Older Men: The Veterans Affairs Normative Aging Study. Nutrients. 2019 Nov 13; 11(11).. View in PubMed
• Association between fluoride exposure and cardiometabolic risk in peripubertal Mexican children. Environ Int. 2020 01; 134:105302.. View in PubMed
• Blood DNA methylation biomarkers of cumulative lead exposure in adults. J Expo Sci Environ Epidemiol. 2021 02; 31(1):108-116.. View in PubMed
• Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors. Environ Health Perspect. 2019 10; 127(10):105001.. View in PubMed
• Cumulative Childhood Lead Levels in Relation to Sleep During Adolescence. J Clin Sleep Med. 2019 10 15; 15(10):1443-1449.. View in PubMed
• Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) Project. BMJ Open. 2019 08 26; 9(8):e030427.. View in PubMed
• Fluoride Content in Foods and Beverages From Mexico City Markets and Supermarkets. Food Nutr Bull. 2019 12; 40(4):514-531.. View in PubMed
• Early lead exposure and childhood adiposity in Mexico city. Int J Hyg Environ Health. 2019 07; 222(6):965-970.. View in PubMed
• Socio-demographic predictors of prepulse inhibition: A prospective study in children and adolescents from Mexico City. Biol Psychol. 2019 07; 145:8-16.. View in PubMed
• Fluoride exposure and pubertal development in children living in Mexico City. Environ Health. 2019 03 29; 18(1):26.. View in PubMed
• Early lead exposure and pubertal development in a Mexico City population. Environ Int. 2019 04; 125:445-451.. View in PubMed
• Blood lead, bone lead and child attention-deficit-hyperactivity-disorder-like behavior. Sci Total Environ. 2019 Apr 01; 659:161-167.. View in PubMed
• The associations between lead exposure at multiple sensitive life periods and dental caries risks in permanent teeth. Sci Total Environ. 2019 Mar 01; 654:1048-1055.. View in PubMed
• Low-Level Cumulative Lead and Resistant Hypertension: A Prospective Study of Men Participating in the Veterans Affairs Normative Aging Study. J Am Heart Assoc. 2018 11 06; 7(21):e010014.. View in PubMed
• Retraction notice to “Paraoxonase I polymorphisms and attention/hyperactivity in school-age children from Mexico City, Mexico” Environmental Research (2014) 342 -349. Environ Res. 2018 11; 167:776.. View in PubMed
• Assessment of neuropsychological performance in Mexico City youth using the Cambridge Neuropsychological Test Automated Battery (CANTAB). J Clin Exp Neuropsychol. 2019 04; 41(3):246-256.. View in PubMed
• Prenatal fluoride exposure and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6-12 years of age in Mexico City. Environ Int. 2018 12; 121(Pt 1):658-666.. View in PubMed
• New Initiative aims at expanding Global Burden of Disease estimates for pollution and climate. Lancet Planet Health. 2018 10; 2(10):e415-e416.. View in PubMed
• Children’s Blood Lead Concentrations from 1988 to 2015 in Mexico City: The Contribution of Lead in Air and Traditional Lead-Glazed Ceramics. Int J Environ Res Public Health. 2018 09 30; 15(10).. View in PubMed
• Extending Tests of Random Effects to Assess for Measurement Invariance in Factor Models. Stat Biosci. 2018 Dec; 10(3):634-650.. View in PubMed

• Chatzi, Vaia
• Peters, Anne
• Farzan, Shohreh
• McConnell, Rob
• Habre, Rima
• Minguez Alarcon, Lidia