Professor Studies Hazard Exposure and Health Disparities among Workers
Diana Ceballos, assistant professor of environmental health, studies the burden of exposure to toxicants in the workplace, community, and home.
When the New York Times published a widely read, two-part exposé of labor abuse and poor working conditions at New York City-area nail salons in 2015, Diana Ceballos was part of a team of occupational health experts called upon by the state Department of Health to assess salon working environments and nail technicians’ exposure to unsafe chemicals.
As a chemical engineer with a PhD in environmental and occupational hygiene, Ceballos was working at the time as an industrial hygienist for the National Institute for Occupational Safety and Health (NIOSH), where she measured and analyzed the impact of workplace hazards on workers’ health—which is one of the federal agencies within the Centers for Disease Control and Prevention (CDC).
Now, as an assistant professor of environmental health, Ceballos combines her scientific expertise with academic research and an unwavering goal to reduce health disparities by addressing the disproportionate burden of exposure to toxicants by vulnerable populations in the workplace, and within their communities and homes. Since joining the School of Public Health two years ago from Harvard T.H. Chan School of Public Health (HSPH), Ceballos has expanded her research on many of the subjects she pursued at NIOSH, including workers’ exposure to toxic chemicals, pollutants, and metals in the nail salon and electronics recycling industries. She teaches Field Methods in Exposure Science at SPH.
Working in the field of public health “feels like home,” says Ceballos. “I’m a big-picture person. During my time at the CDC, I was able to see the larger environmental health issues that were not being solved, and that has inspired much of the work that I do today to understand and reduce health inequities in the environment.”
The toxic exposures and health challenges of nail salon workers—many of whom are undocumented immigrants with limited access to healthcare—in the landmark Times investigation shows that previous ways of evaluating certain public health issues and environments are no longer effective, Ceballos says, adding that in past decades, nail salon environments were deemed safe by health officials. “Social variables play such a big role in the health of underserved populations, and if you don’t take those variables into account, you can’t understand how these populations are so severely affected by their environments.” She has embraced this approach in her research for years, including during her time as a fellow in the JPB Environmental Health Fellows Program at HSPH, which offers training and leadership opportunities to develop solutions and policy changes that address environmental, social, economic, and health disparities across the US.
At SPH, Ceballos has published several studies on toxicants in nail polish and the health impacts resulting from exposure to these chemicals. She led a first-ever study of harmful volatile organic compounds in nail technicians, which found elevated blood levels of toluene and ethyl acetate in technicians’ blood, and that better ventilation can reduce the levels of these compounds in the air they breathe. Shortly before the study was released, the Boston Public Health Commission implemented new requirements for active ventilation in Boston nail salons; Ceballos’ findings further justified the policy change.
“This shows that we were saying the right things, and that our work matters,” says Ceballos. “Nail salon technicians are some of the most inspiring and hard-working people I’ve ever met, and this type of progress makes the job very rewarding.”
Ceballos’ exposure assessment research also extends to electronics recycling. Last fall, she led a first-of-its-kind study to evaluate the exposures of workers on e-waste shredding trucks, which are used to destroy laptops and other electronics containing confidential information. The study found that these workers are exposed to high concentrations of metals when they grind the electronics in poorly ventilated trucks, and without proper protective gear. As e-recycling workers are more likely to be members of racial/ethnic minorities, immigrants, not fluent in English, and/or experience physical and mental disabilities, the industry is an example of how new hazards disproportionately affect populations that face other health inequities.
If there is lead in your home, you don’t have to show signs of lead poisoning to prove that there is an issue.
Compounding these challenges for workers in hazardous industries are “take-home” exposures—exposures to contaminants, such as pesticides and lead, that workers unintentionally bring home from their workplace and put the health of their families or other household members at risk. Ceballos has collaborated with colleagues on several studies about this issue, including one that showed that take-home exposures are not a result of individual recklessness, rather a result of systemic inequities that largely affect people of color, immigrants, low-income workers. In another study, she found that Boston construction workers had twice as much lead dust in their homes as janitorial workers, and that lead levels varied by race/ethnicity and job stability.
“Some things are so obviously toxic that we don’t need to measure health to know that there is a problem,” says Ceballos. “If there is lead in your home, you don’t have to show signs of lead poisoning to prove that there is an issue.”
And while lead exposure has become a well-known public health issue—particularly after the Flint water crisis—more policy changes are needed to spur preventative measures that create safe and equitable work environments, says Ceballos.
“Most of the public health efforts around lead take-home exposure have been isolated and reactionary, rather than preventative,” she says, adding that she hopes that with her research to spur stricter policy and regulation as well as programmatic changes similar to what has been done to mitigate pesticide exposure. “My vision is for the tools that we’re developing to be incorporated into public health departments, HUD [US Department of Housing and Urban Development], and others who can make an impact in practice and training among large groups of people, rather than isolated efforts.”
The physical, mental, and economic impacts of the COVID-19 pandemic have only exacerbated health and safety disparities in the workplace, but the crisis has also shed light on the importance of environmental and occupational research. Ceballos is collaborating with Michael Flynn, program coordinator for NIOSH’s Occupational Health Equity Program (and her former mentor at NIOSH), as well as with academic scholars across the country, on NIOSH-led projects that aim to assemble a network of nonprofit organizations that can educate essential workers and their communities about workers’ health and safety, COVID-19 prevention, and vaccine adoption.
She is also the principal investigator for a COVID-19 study examining whether and how healthcare workers are exposing their families to the virus. The research team also includes Jonathan Levy, chair and professor of environmental health; Jessica Leibler, assistant professor of environmental health; DrPH student Julia Noguchi (SPH’14), and Jennifer Greif Green, an associate professor at BU’s Wheelock College of Education & Human Development.
“We’re developing trainings for healthcare workers and talking to families about the issues they’re facing,” Ceballos says. “A family may know what to do to stay safe, but if they only have one room and the parents have to sleep with the kids, there’s no other option, and that can cause a lot of stress.
“These projects are really exciting and I feel very fortunate coming to BU, where people are genuinely connected to communities and interested in health equity,” she says. “It definitely feels like home.”