Environmental Exposures, Epidemiology, and Health Lab (E3H Lab)

The E3H Lab generates actionable scientific knowledge on the health impacts of environmental exposures — advancing research that protects and strengthens communities locally and globally.

  • Epidemiologic Studies of Environmental Exposures Across the Lifespan
    Investigating health impacts through lactation to pediatric development and chronic disease in adulthood.

  • PFAS Science & Community Engagement
    Studying per- and polyfluoroalkyl substances (PFAS) in partnership with local communities.

  • Translation to Public Health & Clinical Practice
    Transforming research findings into effective interventions and policy solutions.

  • Community Impact in Maine & Beyond
    Supporting the long-term health and vitality of communities locally and globally.

Featured Projects

Environmental Epidemiology
The E3H Lab works in large national and international cohorts to better understand the impact of chemical exposures on long-term health outcomes among adults and children, with a particular focus on chronic disease. Grant-funded projects include:

This study uses data from 1,400 adults enrolled in the nationwide Diabetes Prevention Program (DPP) and DPP Outcomes Study to investigate the impact of PFAS exposure on low muscle mass and strength, low bone mass, and cardiovascular disease in older adults. This study also investigates the extent to which lifestyle behaviors such as physical activity and a healthier diet may mitigate health impacts. This project is a collaboration with investigators at Harvard Pilgrim Healthcare, Harvard School of Public Health, George Washington University, and Stanford University. (NIEHS R01ES024765; PIs: Oken, Fleisch; 2023-2028)

This project prospectively examines the exposome – the totality of all of an individual’s external exposures – along with individual concentrations of multiple contaminants and their molecular mechanisms in relation to Alzheimer’s disease (AD) and AD-related dementias (ADRD). This project uses data from the Diabetes Prevention Program Outcomes Study (DPPOS) AD/ADRD project, and is a collaboration with Columbia University, George Washington University, Stanford University, and the University of North Carolina. (NIA U01AG088684; PIs: Luchsinger, Temprosa, Cardenas, Fleisch, Miller, Starling; 2024-2030)

This study, undertaken in partnership with investigators from the University of Massachusetts and the University of Connecticut, leverages data from the Osteoarthritis Initiative, a multi-center, ten-year observational study of men and women across the US, to examine associations of PFAS with the incidence and severity of hand and knee osteoarthritis. This study is also exploring the extent to which bone health, inflammation, and metabolic factors mediate the relationship between PFAS and osteoarthritis. (NIAMS R01AR081791; PI: Driban; Co-I: Fleisch; 2024-2027)

This study, supported through the National Institute of Environmental Health Sciences (NIEHS) Outstanding New Environmental Scientist (ONES) program, used data from the US Project Viva cohort to investigate dietary predictors of PFAS and phthalates and examine the role of childhood chemical exposure independent of diet on adolescent markers of obesity and osteoporosis risk. This study is in collaboration with investigators from Harvard Pilgrim Health Care Institute and Harvard School of Public Health (NIEHS R01ES030101; PI: Fleisch, 2019-2026)

This project, undertaken in partnership with the Dartmouth Geisel School of Medicine and nested within the New Hampshire Birth Cohort Study, investigates how early life exposure to PFAS may affect child health outcomes as mediated through human milk. (NIEHS CHEAR/HEAR; PI: Romano; Co-I: Criswell; 2019-2020)

Environmental Community-Engaged Research
In response to PFAS contamination in Maine from historical application of PFAS-contaminated biosolids as fertilizer on agricultural land, the E3H Lab partnered with local communities to approach the uncertainty and questions around the contamination with evidence-based, community-engaged research prioritizing consultation with Community Advisory Boards and results report back to participants.

In this project, the E3H Lab partnered with the central Maine community to establish the first cohort of 150 rural adults with PFAS exposure from contaminated biosolids. Participants were recruited through town halls where they completed surveys and provided blood samples. This study characterized PFAS in participants’ water and blood, used survey data to evaluate potential exposure pathways to PFAS in this novel agricultural setting, and characterized associations between learning of PFAS contamination and anxiety and perceptions of health risk and stigmatization. (NIH R21ES035596; PIs: Fleisch, Criswell; 2023-2025)

In this training grant through the Tufts University Clinical and Translational Science Institute (CTSI), the E3H Lab is analyzing PFAS concentrations and the non-targeted human milk proteome in milk samples with a wide range of PFAS exposures from northern New England (Maine, New Hampshire, and Vermont) to better understand how PFAS affects the composition of human milk. A key part of this project is partnership with a Community Advisory Board and development of context-rich, relevant report back materials. (K12TR004384 NIH/NCATS; PIs: Freud, Inker 2023-2028; Scholar: Criswell 2025-2027)

See Recruitment Poster

Environmental clinical care and health literacy/awareness
As practicing physicians, the E3H Lab members are keenly aware of the health and psychosocial concerns experienced by patients affected by high‑level PFAS exposure. In its clinical and research work, the team implements evidence‑based guidelines while also advancing clinical practice informed by the most recent research.

In this project, the E3H Lab is documenting a case series of patients from our clinics treated with the bile acid cholestyramine to reduce elevated levels of PFAS in serum. As part of this project, the team will vet our clinical protocol with a panel of environmental health experts and lived experience experts for finetuning and wider distribution. (Maine CDC funding; PIs: Fleisch, Criswell; 2025-2027)

With funding from the Tufts CTSI Small Grants to Advance Translational Science (S-GATS) and a collaboration between Redington-Fairview General Hospital (RFGH) and the MDI Biological Laboratories, this project seeks to bridge the translational gap between environmental health guidance and clinical practice by creating, iteratively testing, and disseminating a proof-of-concept PFAS Exposure App for Clinicians (PEAC) based on existing guidance from federal and academic bodies. (Tufts CTSI S-GATS; PI: Criswell; 2026-2027)

Building on the successful educational platforms from the PFAS-Research, Education and Action for Community Health (PFAS-REACH) consortium, this project seeks to update and improve existing clinician education through its online CME Nonstick Nuisance and PFAS-Exchange website and establish a national network of clinicians caring for patients affected by PFAS. Dr. Criswell serves at Medical Advisor on this project. (Robert Wood Johnson Foundation; PIs: Brown, Carignan, Schaider; 2026-2027)

See Recruitment Poster

Environmental Exposures, Epidemiology & Health Lab

81 Research Drive
Scarborough, Maine 04074

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