Melissa A. McDiarmid, MD, MPH

I received my B.A. from the University of Maryland Baltimore County in Biological Sciences; my M.D. from the University of Maryland at Baltimore; and my M.P.H. from The Johns Hopkins School of Public Health where I also completed fellowship training in Occupational Medicine. I am board-certified in Internal Medicine, Occupational Medicine and Toxicology.

Research activities in the Division of Occupational and Environmental Medicine continue to provide opportunities for both productive scholarship as well as prevention practice in the community. A major project, which I lead, involves the on-going surveillance of Gulf War and OIF veterans who were victims of "friendly fire" involving depleted uranium (DU) weapons. These veterans possess multiple fragments of DU in their soft tissues, which are not easily accessed surgically.  These retained fragments are oxidizing in-situ and therefore raise the patient's systemic body burden of uranium. While only weakly radioactive, the uranium toxicity of concern is primarily from the heavy metal chemical hazard it poses. Our clinical investigations focus on the early detection of sentinel effects of this uranium burden on the health of these veterans.

A related project has focused on methods development to allow the assessment of uranium burden and sentinel health effects via mail. As the only center for DU surveillance worldwide, we receive requests for urine uranium testing from veterans nationally and internationally.  Expertise developed from this project has been applied to offer other biologic monitoring services to wounded Veterans that measure the body burden of toxic metals found in improvised explosive devices (IEDs). These results are then applied to guide clinical patient management.

Clinical toxicology applications of my work focus on the surveillance of healthcare workers exposed to chemical hazards in the course of their work. Of special interest is the risk of health harm to workers from preparing and administering anti-cancer chemotherapy. These drugs are well known for their acute and chronic toxicity in treated patients, but they also impose a risk to workers, most notably adverse reproductive outcomes and possibly cancer. We are engaged in several projects to enhance the safety practices used to handle these clinically important drugs.

I am also a member of the Population Science Program within the University of Maryland Marlene and Stewart Greenebaum Cancer Center Program in Oncology. Population Science researchers collaborate with investigators throughout the University of Maryland System to identify determinants of cancer etiology and survivorship, characterize cancer-related health behaviors, and translate basic discoveries into behavioral cancer prevention and control interventions. My research interests are in occupational and environmental determinants of cancer, second malignancy development in chemotherapy treated patients, the cancer risk of oncology workers and chemotherapy safety.

In 2009 our Division was named a Pan American Health Organization/World Health Organization (PAHO/WHO) Collaborating Center in Occupational Health. In this role, our staff provides technical expertise and content knowledge in support of the WHO Global Plan of Action on Workers Health with an emphasis on the healthcare sector including assistance with the Ebola and Covid responses and the reciprocal Duty of Care during public health emergencies. In a related global health effort, she leads a University of Maryland longitudinal project to support the Ministry of Health in The Gambia, West Africa in providing prevention services for the health workforce, including developing legislation to ensure minimum standards of health protection.

My clinical practice involves the assessment and management of patients who are occupationally or environmentally exposed to toxic substances. We also design and provide OSHA-mandated surveillance programs for high-risk workers. Ultimately, we promote prevention to our patients, our students and the wider public.

Occupational medicine, clinical toxicology, healthcare hazards, global workers' health, exposure assessment

McDiarmid, M., Crestani, R. Duty of care and health worker protections in the age of Ebola: Lessons from Médecins Sans Frontières. BMJ Glob. Health 2019, 4, e001593

McDiarmid, M, Harrison R, Nicas M. N95 Respirators vs Medical Masks in Outpatient Settings. JAMA. 2020 Feb 25;323(8):789. doi: 10.1001/jama.2019.20905. PMID: 32096840.

McDiarmid, MA, Hines, SE, Cloeren, M, Gucer, P, Condon, M, Oliver, M, Roth, T,  Lewin-Smith, MR, Strathmann, F, Velez-Quinones MA, Gaitens, JM. The Department of Veterans Affairs Depleted Uranium Cohort during COVID-19: Translating a Traditional Surveillance Protocol to a Telehealth Platform. Journal of Occupational and Environmental Medicine, J Occup Environ Med. 2023 Aug 1;65(8):670-676. doi: 10.1097/JOM.0000000000002875. Epub 2023 May 12. PMID: 37167933; PMCID: PMC10417219.

Manjang, B., Keita, E., Bittaye, S., Jallow, B., Mbye, S., Badjie, A., Touray, I., Bojang, L., Tamba, S., Kebbeh, L., Bojang, L., Kanyi, S., Sanneh, M., Ceesay, N., Gaitens, J., LeBuhn, H., & McDiarmid, M. (2024). Hepatitis B serology testing and vaccination for Gambian healthcare workers: A pilot study. Journal of Public Health in Africa, 15(1), 6 pages. doi:https://doi.org/10.4102/jphia.v15i1.489

McDiarmid, MA, Gaitens, JM, Almashat, S, Cloeren, M, Condon, M, Oliver, M, Roth, T, Gucer, P, Brown, CH, Whitlatch, B, Wang, KC, Patel, JB, Dux, M, Lee-Wilk, T, Lee, D, Lewin-Smith, MR, Xu, H, Strathmann, FG, Koslowski, JA, Velez-Quinones, MA. Thirty years of surveillance of depleted uranium-exposed Gulf War veterans demonstrates continued effects to bone health. Journal of Toxicology and Environmental Health, Part A; DOI:10.1080/15287394.2024.2432021.