Fact Sheets & Subject Matter Expert Quotes

Clayton T. Cowl, MD, MS, FCCP, is triple board-certified in pulmonary and critical care medicine, occupational medicine and internal medicine with an interest in airway disorders, occupational-related respiratory health, toxicology, altitude physiology, aviation medicine and transportation medicine. Dr. Cowl is the President-Designate and sits as a member of the Board of Regents of the American College of Chest Physicians (CHEST) and is Chair of the Division of Preventive, Occupational and Aerospace Medicine with a joint appointment in the Division of Pulmonary and Critical Care Medicine at Mayo Clinic in Rochester, Minnesota.

His research focus has included projects in altitude physiology at Mayo Clinic’s altitude chamber where testing for the emergency oxygen mask for passengers in the new Boeing 787 was completed. He has also published in the areas of occupational asthma and toxic inhalations. Dr. Cowl is currently the President of the Civil Aviation Medical Association and is a Senior Aviation Medical Examiner designated by the Federal Aviation Administration. In 2015, Dr. Cowl received the Innovation in Education Award from the Mayo School of Continuous Professional Development, Mayo Clinic College of Medicine, for work on developing and leading a course training physicians and advanced nurse practitioners on performing medical certification examination on commercial truck and bus drivers.

Areas of expertise

• Pulmonary medicine
• Airway disorders (asthma, COPD, toxic inhalations, etc.)
• Occupational-related respiratory illness
• Altitude physiology and aviation medicine
• Transportation medicine (truck, air, rail, maritime, etc.)
• Toxicology

Key facts

• Work-related exposures are estimated to account for about 15 percent of all adult asthma cases.
  • About 11 percent of spray painters exposed to diisocyanate-based paints have bronchial hyperactivity.
  • Roughly 5 percent of workers in the lumber industry exposed to Western Red cedar dust developed asthma.
  • About 2.5 percent of all workers exposed to natural latex have reported occupational asthma.
    

• Despite asbestos mining and distribution use being banned in the United States, incidence rates of asbestosis and asbestos-related lung cancers have climbed in certain areas of the world where the fiber is still mined and marketed. Mesothelioma rates are forecast to continue rising worldwide, owing to the long latency of the disease.
• Based on a three-year period from 2008 to 2010, the incidence of inflight medical emergencies was estimated to be one per 604 commercial airline flights. Neurologic, respiratory, GI and cardiac problems are responsible for the most serious events during flight and account for the majority of flight diversions.
  

Dr. Cowl on the topic of truck driver safety:

“The health of truck drivers impacts safety. By nature of their profession, many truckers live a sedentary lifestyle, which produces a downstream effect. They are at risk of developing obstructive sleep apnea, high blood pressure, diabetes, congestive heart failure and pulmonary hypertension. Healthcare providers should be aware of this when commercial truckers go in for exams to make sure the drivers are properly screened and treated. Then we may see a decrease of accidents on the road.”

Burt Lesnick, MD, FCCP, is a board-certified pediatric pulmonologist with an interest in the asthma, influenza, vaccination as well as respiratory issues of premature infants. Dr. Lesnick is the Medical Director of the Children's Care Network and serves on the Board of Regents of the American College of Chest Physicians (CHEST) as a Regent-at-Large. Dr. Lesnick is a founding board member of the Pediatric Healthcare Improvement Coalition of Georgia.

Areas of expertise

• Pediatric pulmonology
• Asthma
• Influenza
• Vaccinations
• Pediatric lung health

Key facts

• In the United States, 18.7 million adults and 6.8 million children suffer from asthma. (Source: According to the Summary of Health Statistics, National Health Interview Survey, 2012)
• The greatest rise in asthma rates was among black children (almost a 50 percent increase) from 2001 through 2009. (Source: CDC Vital Signs)
• In 2008, less than half of people with asthma reported being taught how to avoid triggers. Almost half (48 percent) of adults who were taught how to avoid triggers did not follow most of this advice. (Source: CDC Vital Signs)
• Children with food allergy are two to four times more likely to have other related conditions such as asthma and other allergies, compared with children without food allergies. (Source: Food Allergy Research and Education)

Dr. Lesnick in the media

"For you and me [a respiratory virus is] a really bad head cold but for those children at risk it can be life threatening."
"RSV: Respiratory virus can be life threatening" (CNN)

Barbara A. Phillips, MD, MSPH, FCCP, is a sleep medicine pulmonologist board-certified in internal medicine and pulmonary medicine, with an interest in the effects of sleep apnea on performance and outcomes, genetic risk factors for sleep apnea, nonpharmacologic treatment of sleep apnea and sleep in aging. Dr. Phillips is the Immediate Past President of the American College of Chest Physicians (CHEST); a Professor of Pulmonary, Critical Care, and Sleep Medicine in the Department of Internal Medicine; and Medical Director of the Sleep Laboratory at the University of Kentucky College of Medicine. Dr. Phillips chaired the National Sleep Foundation and has served on the boards of the American Lung Association, the American Academy of Sleep Medicine and the American Board of Sleep Medicine. In 2011, Dr. Phillips received the Excellence in Education Award from the American Academy of Sleep Medicine. Dr. Phillips also received the Sleep Academic Award from the National Institutes of Health and was presented with the College Medalist Award at CHEST 2013.

Areas of expertise

• Sleep apnea
• Healthy sleep
• Treatment for sleep disorders
• Lifestyle and sleep
• Sleep deprivation
• Importance of sleep for mothers
• Sleep and occupational risks (commercial drivers)

Key facts

• More than 18 million American adults have sleep apnea. (Source: American Academy of Sleep Medicine)
• There are a number of factors that increase risk for sleep apnea, including the following:
  • Having a small upper airway (or large tongue, tonsils or uvula).
  • Being overweight.
  • Having a recessed chin, small jaw, large overbite, a large neck size (17 inches or greater in a man, or 16 inches or greater in a woman).
  • Smoking and alcohol use.
  • Being age 40 or older.
  • Ethnicity (African-Americans, Pacific-Islanders and Hispanics).
  • Also, OSA seems to run in some families, suggesting a possible genetic basis. (Source: American Academy of Sleep Medicine)
• Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. (Source: National Heart, Lung and Blood Institute)
• Sleep apnea often goes undiagnosed. Doctors usually can't detect the condition during routine office visits. Also, no blood test can help diagnose the condition. (Source: National Heart, Lung and Blood Institute)
• Most people who have sleep apnea don't know they have it because it only occurs during sleep. A family member or bed partner might be the first to notice signs of sleep apnea. (Source: National Heart, Lung and Blood Institute)
• The lack of oxygen caused by sleep apnea can cause high blood pressure, heart disease, stroke, prediabetes, diabetes and depression. (Source: American Academy of Sleep Medicine)

Dr. Phillips on the topic of sleep

“Three tips for a better night sleep: (1) make sleep a priority; (2) make the environment conducive to sleep—dark, cold and quiet; (3) avoid drugs and substances that interrupt sleep.”

“At the heart of it, this issue is about patient care and outcomes. There simply aren’t enough board-certified sleep specialists to manage the 10% to 15% of our population who has sleep-disordered breathing. I think pulmonologists need to take sleep apnea back!” Sleep Review, Feb 2016

“The Multiple Sleep Latency Test is not it!” Phillips says. She adds, “A huge elephant in the room, at least from my point of view, is we still don’t know what sleep apnea is or how best to measure it. It will remain difficult to assess epidemiology, consequences, or treatment effects for sleep apnea until that is done. Personally, I think the AHI is a very flawed metric.” Sleep Review, Feb 2016

Phillips states, “Frankly, I don’t think that either sleeping pills or insomnia is particularly dangerous; I think it is the characteristics of people who report insomnia and who use sleeping pills chronically that lead to the adverse outcomes reported. This issue needs careful study.” Sleep Review, Feb 2016

"The timing of exercise ought to be driven by when the pool's lap lane is open, or when your tennis partner is available or when you have time to get away from work," [because exercise is so important for good sleep and good health.] (p 202, The Sleep Revolution, 2016)

Dr. Phillips video and article samples

“Working With Current Sleep Apnea Treatments While Looking to The Future” MD Magazine TV

“Managing Central Sleep Apnea With Advancements in Treatments of Obstructive Sleep Apnea” MD Magazine TV

“Weighing the Benefits of Home Sleep Studies” MD Magazine TV

“Living and Breathing Sleep” Sleep Review

“Barbara Phillips, MD, Elected President of American College of Chest Physicians” Sleep Review

Mark J. Rosen, MD, Master FCCP, is a board-certified pulmonary and critical care physician with special interests in COPD, respiratory infections and sepsis. Dr. Rosen is currently Professor of Medicine at the Icahn Mount Sinai School of Medicine and Medical Director of the Mount Sinai-National Jewish Respiratory Institute and a Past President of the American College of Chest Physicians (CHEST). Dr. Rosen has more than 30 years of regional, national and international experience as a clinician and educator in pulmonary and critical care medicine. Dr. Rosen served for 20 years as Chief of the Division of Pulmonary, Critical Care and Sleep Medicine at two major New York academic medical centers and authored over a hundred articles and book chapters covering a breadth of clinical topics in pulmonary and critical care medicine.

Areas of expertise

• COPD
• Cough
• Pulmonary infections
• Sepsis
• Medical ethics and end-of-life care

Key facts

• COPD is the fourth-leading cause of death in the world.
• Every year, severe sepsis strikes more than a million Americans.
• Between 28 to 50 percent of people who are affected by sepsis die—far more than the number of U.S. deaths from prostate cancer, breast cancer and AIDS combined.

Quotes from Dr. Rosen

“One of the key features of the science of sepsis in the last year or two has been relooking at the definition. How do you define sepsis? The definition will then drive diagnosis and treatment. The definition is not only looking at the low blood pressure, high pulse and treatment of inflammation but rather looking and focusing on the results of it: what are the organs doing as a result of the infection?”

Dr. Rosen video and article samples

Update in Critical Care

Sepsis Overview at CHEST 2016

Curtis N. Sessler, MD, FCCP,  is a pulmonologist with a focus on critical care. Dr. Sessler is the Immediate Past President of CHEST, the Orhan Muren Distinguished Professor of Medicine at Virginia Commonwealth University (VCU) Health System, Director of the Center for Adult Critical Care and Medical Director of Critical Care at VCU. Dr. Sessler is an enthusiastic and award-winning clinician and educator. His clinical and research interests include sedation and analgesia in the ICU, respiratory failure and optimizing safe and effective critical care delivery. He is a member of various editorial boards including CHEST and is editor in chief of CHEST SEEK Critical Care Medicine. He received the Roger C. Bone Memorial Lecture award from CHEST in 2010. He is Past President of the Virginia Thoracic Society, has served on several committees for the U.S. Food and Drug Administration and is on a variety of national multisociety task forces related to critical care. 

Areas of expertise

• Sepsis
• Critical care
• Burnout syndrome for critical care providers
• Respiratory failure
• Ethics in the ICU

Key facts

• Compared with a probability-based sample or working adults, physicians were 36 percent more likely to develop burnout syndrome (BOS). Among physicians, those at the front line of care (family medicine, emergency medicine and general internal medicine) report the highest rates of BOS (ie, >40 percent). (Source: “Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population,” Archive of Internal Medicine)
• Critical care health care professionals have one of the highest rates of BOS (ie, >50 percent), and development of this disorder may adversely affect the ability to care for patients properly. (Source: “Medscape Physician Lifestyle Report 2015”)
• Based upon multiple studies, approximately 25 percent to 33 percent of critical care nurses manifest symptoms of severe BOS, and up to 86 percent have at least one of the three classic symptoms. (Source: CHEST)
• Up to 45 percent of critical care physicians reported symptoms of severe BOS. In pediatric critical care physicians, the prevalence of BOS is 71 percent, more than twice the rate in general pediatricians. (Source: CHEST)
• The number of times people were in the hospital with sepsis or septicemia increased from 621,000 in the year 2000 to 1,141,000 in 2008. (Source: CDC)

Dr. Sessler on the topic of critical care medicine:

“We need to do better to support critical care clinicians. They work hard and do their best to give great care, but many are under extra stress caring for patients who are in pain and suffering. They are more likely to burnout and possibly make mistakes.”

Gerard A. Silvestri, MD, MS, FCCP, is an international expert in lung cancer and interventional pulmonology. He completed his training in pulmonary and critical care at Dartmouth and has served on the faculty at the Medical University of South Carolina for nearly 25 years. He is the President of the American College of Chest Physicians, the George Sr. and Margaret Hillenbrand Professor of Thoracic Oncology and Vice-Chair of Medicine for faculty development at the Medical University of South Carolina in Charleston. His research includes screening for lung cancer, how patients should be diagnosed and staged with the disease and how to evaluate new technologies needed to diagnose and treat these patients. Dr. Silvestri is a writer and editor of the American College of Chest Physicians lung cancer guidelines. He is a past president of the American Association of Bronchology and Interventional Pulmonology. Dr. Silvestri has authored more than 200 scientific articles, book chapters and editorials. He has served on multiple editorial boards of medical journals and currently serves on the editorial board of the journal CHEST. Dr. Silvestri was awarded the Pasquale Ciaglia Memorial Lecture in Interventional Pulmonary Medicine in 2012, which recognizes career contributions to that field, and the Edward C. Rosenow III, MD, Master FCCP/Master Teacher Honor Lecture in 2014 by CHEST.

Areas of expertise

• Lung cancer and lung cancer screening
• Women and lung cancer
• Lung cancer stigma
• Smoking and lung cancer
• Genetics and lung cancer

Key facts

• Lung cancer is the most common cancer worldwide, accounting for 1.8 million new cases in 2012, and is responsible for nearly one in five cancer deaths. (Source: CHEST WLCD Fact Sheet)
• Lung cancer claims more lives yearly than breast, colon and prostate cancers combined. (Source: CHEST WLCD Fact Sheet)
• Tobacco use is the most significant risk factor for cancer causing an estimated 70 percent of global lung cancer deaths. (Source: CHEST WLCD Fact Sheet)
• The risk of getting lung cancer increases with age is greater in men than in women. (Source: CHEST WLCD Fact Sheet)
• One in five patients diagnosed with lung cancer are nonsmokers. (Source: http://www.cancer.org/cancer/news/features/why-lung-cancer-strikes-nonsmokers)
• Radon, asbestos, arsenic, beryllium and uranium have all been linked to lung cancer. (Source: CDC)

Dr. Silvestri on the topic of lung cancer

“Unlike other cancers, it is not productive for everyone to be screened for lung cancer. I would recommend that anyone who is of high-risk for lung cancer be screened yearly.”

“More women will die from lung cancer compared to all women’s cancer like breast cancer, ovarian cancer, uterine cancer, cervical cancer, combined. Further, 15 percent of women diagnosed with lung cancer are nonsmokers.”

“We need to change the viewpoint that lung cancer is something that the patients brought onto themselves. There are several different factors that play into lung cancer and many of our patients are nonsmokers.”

“Treatments for lung cancer are not one size fits all.”

Dr. Silvestri video and soundbite samples

Elsevier author interview

“How will this policy statement guide screening program?” CHEST

“What is the background on lung cancer screening? Where are we headed?” CHEST

“How might the policy statement help craft policy with CMS” CHEST

Dr. Silvestri on lung cancer and the need for research

“How a Diagnosis of Lung Cancer is Made: The Biopsy” Cancer Grace

“Staging Lung Cancer Presentation at the NSCLC Patient Education Forum” Cancer Grace

John Studdard, MD, FCCP, is a pulmonary and critical care physician in private practice with Jackson Pulmonary Associates in Jackson, Mississippi. Dr. Studdard is currently the President-Elect of the American College of Chest Physicians (CHEST). He is board-certified in internal medicine and pulmonary disease by the American Board of Internal Medicine. Dr. Studdard’s dedication to reducing the number of patients he treats for tobacco-related diseases and his leadership qualities led him to serve as representative for CHEST in the negotiations with the tobacco industry leading to the attorneys general Master Settlement Agreement of 1998.

Areas of expertise

• e-Cigarettes
• COPD 
• Asthma 
• Critical care 
• Smoking and smoking cessation 
• Patient education 
• Patient-physician communication

Key facts 

• The number of never-smoking youth who used e-cigarettes increased from 79,000 in 2011 to more than 263,000 in 2013. (Source: CDC)
• In 2011, about 21 percent of adults who smoke traditional cigarettes had used e-cigarettes, up from about 10 percent in 2010. (Source: CDC)
• Overall, about six percent of all adults have tried e-cigarettes, with estimates nearly doubling from 2010. (Source: CDC)
• e-Cigarette use among U.S. middle school students doubled from 1.4 percent to 2.7 percent in 2012. (Source: CDC)
• Nearly one in four high school students (24.6 percent) in the United States use at least one tobacco product, and more than 50 percent of these youth that use tobacco products report using two or more tobacco products. (Source: CDC)
• COPD is the third leading cause of death in the United States. More than 11 million people have been diagnosed with COPD, but an estimated 24 million may have the disease without even knowing it. (Source: American Lung Association)

Dr. Studdard on the topic of e-Cigarettes 

“e-Cigarettes are not a tool for quitting smoking. There is no control over what is in e-cigarettes, and there are far too many unknowns about e-cigarettes. There are better pharmaceutical options to help with quitting smoking.”

“If a patient in the hospital needs to quit smoking, they are in the best place to start. A great time to start the quitting process is when a patient is in the hospital surrounded by staff to assist in getting started.”

“One of the hardest parts of our job is to share bad news with our patients. There needs to be a balance of professionalism, information giving and compassion. I believe there should be more training around how to tell a patient bad news, such as having cancer.”

Dr. Studdard video and article sample

“USA: Landmark Tobacco Lawsuit Preview” AP Archive