From Ophthalmology to Environmental Public Health – a Life Well Traveled

Unlike many others who embark on a career in public health upon graduating from college, Bruce Tierney, M.D.,  Captain, United States Public Health Service, and Senior Medical Officer, Division of Community Health Investigations, Agency for Toxic Substances and Disease Registry (ATSDR) came into public health by a most unusual route.

The Road to Professional Fulfillment Can Have Many Detours

Arriving in Atlanta at the age of six with his parents in 1965, along with the Braves and Falcons, Dr. Tierney grew up on the Southside of Georgia. His father, a Delta Airlines employee, inspired in him a lifelong love of aviation and travel.

Dr. Tierney was interested in architecture in high school but ultimately chose medicine as a career path, completing undergraduate studies in chemistry and then a doctorate in medicine at Emory in 1986, the last three years of which were courtesy of an army scholarship. Owing his post-graduate internship and residency in internal medicine plus two additional years to the Department of the Army, he honored that commitment at Fort Gordon in Augusta, Georgia, at the Eisenhower Medical Center.

During his post-graduate training, he became interested in ophthalmology. Before starting residency training for this specialty, however, he chose to be a general medical officer and flight surgeon because of his interest in aviation. After completing the required flight surgeon training course, which in 1987 included 15 hours of flight training in a helicopter, he spent one year in Korea as a flight surgeon, departing just as the Olympics were beginning there in 1988.

Upon his return to the U.S., Dr. Tierney worked in the school of aviation medicine for the army at Fort Rucker in Alabama. There he had a choice between doing a residency in aerospace medicine, a specialized field of a preventive medicine residency, but instead pursued his earlier desire to complete a residency in ophthalmology, which he did in 1993 at the Brooke Army Medical Center in Fort Sam Houston in Texas.  Owing another two years to the Army after that, he served as a practicing ophthalmologist at Reynolds Army Community Hospital, Fort Sill, Oklahoma.

A Calling to Public Health

After nine years total in the army, Dr. Tierney returned home to Atlanta to begin in private practice as an ophthalmologist, also retaining his commission in the army as a reserve officer. He practiced ophthalmology for about 5 years, but found that he missed the comradery of the military and working in a large group of people. So he started looking for different opportunities. He discovered theEpidemic Intelligence Service (EIS) program at CDC, applied, and was accepted into the program in 2001, transferring his commission in the army as a reserve officer to the Commissioned Corps.

He was immediately involved in the Anthrax Vaccine Safety Activity because of his military experience with the anthrax vaccine. The vaccine was used on a regular basis in the military because of the concern of its potential use as a weapon during Desert Storm in the early 1990s. His EIS work on the Anthrax Vaccine Safety Activity coincided with 9/11 and the anthrax outbreaks that occurred shortly thereafter.

At the end of his EIS training, Dr. Tierney went to work in the Division of Health Care Quality Promotion at CDC, previously the Hospitals Infections Program, and remained there for 5 years before transferring to work on ATSDR’s Exposure Investigation Team.

Exposure Investigations

In his role on ATSDR’s Exposure Investigation Team (EIT), Dr. Tierney helps with the medical side of exposure investigations. EIT is a team of six who undertake investigations that meet specific program criteria. The team gets requests from ATSDR’s 10 regional offices throughout the U.S.; in other health agencies; federal, state or regional health and environmental departments, like the ATSDR Partnership to Promote Local Efforts to Reduce Environmental Exposure (APPLETREE) partners and the Environmental Protection Agency (EPA); and occasionally the general public.

EIT scientists serve as impartial investigators, collecting and analyzing biological (blood or urine) and/or environmental (water, air, soil, dust) sampling. Their goal is to go into a community, identify people who may have been exposed to a chemical from industry or the natural environment, and test them for possible biological or environmental exposures.

They then assist the community by making recommendations to the state and to EPA that may include consideringa health study (if warranted), to reduce exposure from the environmental contaminants, or conduct a public health assessment to give people a sense of potential health impacts.

What are PFAS?

One EIT investigation of particular significance to Dr. Tierney involved a 2010 per- and polyfluoroalkyl substances (PFAS) contamination in Decatur, Alabama, stemming from a production industry near the Tennessee River. The industry released these chemicals into the river, which residents use as a water supply.

“Fifteen years ago, people were not aware of the potential environmental hazards of these man-made chemicals that have been in use since WWII,” says Tierney. “These chemicals were put into application in many things we all use in everyday life such as stain guarding material used to upholster furniture, rugs and carpets, non-stick Teflon for frying pans, and fire retardants. PFAS do not easily break down and can remain in the environment for a long time, and contaminate water, fish, and soil, creating potential exposure to humans and animals.”

Dr. Tierney and his colleagues are very passionate about helping communities and educating local medical personnel about these exposures, what they might mean, and what to look for. He finds this work very satisfying and believes this field is where he and his colleagues have the greatest positive impact. “Every community investigation, just like every affected individual, is different based on the level of exposure,” says Tierney.

The Face of ATSDR

Where ever they go, and with everyone whom they interact, EIT is the face of ATSDR. They gather their own unique data, specific to a particular community, in order to answer public health questions. This data may be of value not only to an investigation in another area with a similar exposure but also to the greater scientific community at-large. EIT collects data by doing biomonitoring and environmental sampling within the community itself, while respecting and protecting the privacy of its citizens. They are not behind desks in ATSDR’s Atlanta headquarter office or Regional Offices, but actually on the ground in communities.

Helping people on a broad scale through community outreach efforts appeals to Dr. Tierney. What can be more gratifying than ensuring safe air, water, and a safe environment in which to live? These elements are basic to life and vital to our subsistence.

A Life Well Traveled

The road to happiness and self-fulfillment can have many detours. On a personal level, Dr. Tierney’s life has been equally as exploratory as his professional life, thanks to the travel bug passed on by his father. He has been to over 75 countries and 6 continents (on his own dime and time), saving a trip to Australia for retirement.

Dr. Pamela Ching, a Commissioned Corps Officer who works in CDC’s National Immunization Program has been his partner for over 18 years. “We met on the internet,” he says. “We enjoy taking care of our new home, having parties, and traveling together.”

Despite his extensive education, training, experience, and travels abroad, Dr. Tierney considers himself to be a boring individual. This fact speaks to his humility, a trait far from unique among public health champions. He is one of many who could have had or left behind more lucrative careers in the private sector to pursue a life of public service. To serve something greater than oneself and make significant differences not only in public health but also in improving the environment, for the benefit of future generations.