Tony Fletcher


Associate Professor

Room 229

15-17 Tavistock Place
United Kingdom

+44 (0)20 7927 2429

My employment is divided between part-time appointments at the London School of Hygiene and Tropical Medicine and the UK Health Security Agency.  I have been at LSHTM since 1992, and UKHSA (formerly PHE) since 2013. At UKHSA, I work in the UK National Institute of Health Research funded Health Protection Research Units with teams at Leicester University, King’s College London, and Imperial College. At LSHTM, I contribute to several studies of perfluorinated alkyl substance, PFAS-exposed communities in Ronneby, Sweden and in Veneto, Italy; and the PROTECT study of COVID-19 transmission at the workplace.

I was Adjunct Research Professor in Environmental Health in the School of Public Health, Boston University, Massachusetts, USA, 2007-2017 and elected President of the International Society for Environmental Epidemiology: Presidential term 2004-5.

Previously employed at IARC, Lyon; MRC Environmental Epidemiology Unit, Southampton, Birmingham University; Aston Universities. 


Department of Public Health, Environments and Society


I contribute to teaching on the Public Health Msc, in particular for the Environmental Epidemiology Module, and Environmental Health Policy in the Environmental Health stream.


My principal research interests are environmental epidemiology (predominately on disease risks in relation to drinking water contaminants; cancer in relation to occupation, arsenic and drinking water; and respiratory disease in relation to air pollution) and environmental health risk assessment (embracing quantitative risk assessment, risk perception, environmental health policy making in general and standard setting for chemicals in particular). A major recent effort has been on perfluorinated chemicals.

I am co-investigator on studies of health effects of perfluoroalkyl substance (PFAS) fire fighting foam exposures in Sweden. This programme led by Gothenberg and Lund Universities, is in a community exposed via drinking water exposure contaminated by fire fighting foams from a nearby military airfield. I am PI on project funded by FORMAS: “The role of renal and intestinal pathways for elimination and half-life of perfluorinated alkyl acids”. I am co-investigator in three projects funded by FORTE, on analyses of serum PFAS and serum hormones and lipids, on exposure modelling and on birth outcome/infant health in relation to in-utero exposure to PFAS 

I am co-investigator on studies of health effects of perfluoroalkyl substance (PFAS) in drinking water in Veneto Italy: “Cross-sectional epidemiological study on the association between internal dose of PFAS and anthropometric and bio-humoral parameters in the exposed Veneto population”, (University of Padova).

Past research

C8 Science Panel Community study.

I co-directed an epidemiological research programme on the potential health effects of Perfluoro-octanoic acid (PFOA or C8) and other perfluorinated chemicals in a community adjacent to a Teflon manufacturing facility in West Virginia, USA. These studies include a cross sectional study of Cancer, Immune function, Liver and Hormone disorders in the community and a Geographical Study of Cancer Incidence in the counties around the plant. More details at

Other past funded research:

PURE - Pollutants in the Urban Environment. Funded by UK EPSRC - Engineering and Physical Science Research Council.

In Collaboration with Universities of Manchester, Sheffield and Cardiff, we have developed developed a systematic method for integrating health and environmental impacts of urban pollutants. I am coordinating the LSHTM team input. 2005-2009.

SAFIR - Safe and High Quality Food Production using Low Quality Waters and Improved Irrigation Systems and Management.

European Union FP6 funding. Working with agricultural scientists, I was coordinating the LSHTM team input on epidemiology and risk assessment of new irrigation technologies. 2005-2009. 2006-2009

INTARESE - Integrated Assessment Of Health Risks From Environmental Stressors In Europe

European Union FP6 funding. I have been contributing in particular to input on Europe wide risk assessment of water related environmental health risks. 2006-2010

Arsenic Health Risk Assessment and Molecular Epidemiology "ASHRAM"

Coordinating international project of 7 teams, funded under the EU Quality of Life programme. It is a case control study of three cancers (bladder, skin, and kidney) in relation to the cumulative ingestion of arsenic via drinking water, in some areas of Hungary, Romania, and Slovakia. Research partners in those countries plus Austria and Sweden. Project has components which will assess the effect of inter-individual variation in arsenic metabolism and DNA repair on the carcinogenic risk of arsenic. Jan 2002-December 2004.

Pollution and the Young "PATY"

Coordinating international project of 14 teams, funded under the EU Quality of Life programme. It entails a reanalysis of a global set of datasets of studies of childhood respiratory health and air pollution, with Participation from Austria, Bulgaria, Germany, Italy, Hungary, the Netherlands, Poland, Russia, Czech Republic, Slovakia, Switzerland, USA and UK. Total study population involves some 70,000 children from 140 areas. December 2002 - November 2004.

Occupation, environment and lung cancer in Central and Eastern Europe

Providing LSHTM input (exposure assessment component) into this case control study with 6 Eastern European partners and co-ordinated by WHO/IARC Lyon. Field work took place in Russia, Hungary, Poland, Romania, Poland and Belarus. Linked studies are ongoing in the same areas addressing risk factors for oral cavity, larynx and kidney cancers. Funded by EC INCO-COPERNICUS programme and US National Cancer Institute.

9 cities study of air pollution and childhood respiratory health

In the Russian Federation and World Bank/CPPI Russian Environmental Management Project (overall coordination by Harvard School of Public Health), 1997-2000.

Community based arsenic mitigation model: validation by epidemiological methods

Worked with Dhaka Community Hospital on protocol development and pilot phase. Funded by DFID Bangladesh, March 2000-March 2001.

CESAR - Central European Study of Air Pollution and Respiratory Health

In 25 communities in Bulgaria, Czech and Slovak Republics, Hungary, Poland and Romania. This is a cross-sectional study of respiratory symptoms, including asthma, and lung function in 7-11 years olds related to current and (estimated) chronic exposure to particulate and gaseous contaminants. Directed sub-project on risk perception and communication within same research programme. First phase funded by EC-PHARE Programme 1994-97; Second phase funded by EC INCO-COPERNICUS Programme 1998-2000.

Chemical Incident Health Impact Prediction Model

Principal Investigator for the project, 1997-1999. Development of a model for the prediction of health impact in the event of large scale chemical incident on Canvey Island Essex, UK. Funded by Department of Health 1997-1999.

SAGE - Small Area Geographical study of Environmental Factors in Health

Principal Investigator. A study of the relationship between environmental factors and ill-health right across the Greater London area, focusing in particular on estimated outdoor air pollution levels and road traffic density in relation to cardio-respiratory deaths and hospital emergency admissions. Funded by North and South ThamesRegional Health Authorities. 1996-98


ISEE: President of the ISEE - International Society for Environmental Epidemiology. Presidential term 2004 & 2005 ARTS: Advisor on contemporary arts commissions and exhibitions programme at the School. WATCH: Member of the Working Group on the Assessment of Toxic Chemicals ("WATCH"), providing advice on setting occupational exposure limits for chemicals, within the UK Health and Safety Commission. The Big Smoke: Lead organiser of 50th anniversary commemorative conference on the 1952 London Smog episode. December 9-10 2002.  Health at the Crossroads - Transport Policy and Urban Health, LSHTM Fifth Public Health Forum: Conference coordinator. April 1995.

Research Area
Environmental Health
Disease and Health Conditions
Euro area

Selected Publications

Risk factors for SARS-Cov-2 infection at a United Kingdom electricity-generating company: a test-negative design case-control study
Rutter C; Van Tongeren M; Fletcher T; Rhodes S; Chen Y; Hall I; Warren N; Pearce N
Associations between Mixture of Perfluoroalkyl Substances and Lipid Profile in a Highly Exposed Adult Community in the Veneto Region.
Batzella E; Zare Jeddi M; Pitter G; Russo F; Fletcher T; Canova C
International journal of environmental research and public health
Transmission and Control of SARS-CoV-2 in the Food Production Sector: A Rapid Narrative Review of the Literature.
Hosseini P; Mueller W; Rhodes S; Pembrey L; van Tongeren M; Pearce N; Loh M; Fletcher T
International journal of environmental research and public health
PFAS Concentrations and Cardiometabolic Traits in Highly Exposed Children and Adolescents.
Canova C; Di Nisio A; Barbieri G; Russo F; Fletcher T; Batzella E; Dalla Zuanna T; Pitter G
International Journal of Environmental Research and Public Health
PFAS Concentrations and Cardiometabolic Traits in Highly Exposed Children and Adolescents
Canova C; Nisio AD; Barbieri G; Russo F; Fletcher T; Dalla Zuanna T; Pitter G
Systemic PFOS and PFOA exposure and disturbed lipid homeostasis in humans: what do we know and what not?
Fragki S; Dirven H; Fletcher T; Grasl-Kraupp B; Bjerve Gützkow K; Hoogenboom R; Kersten S; Lindeman B; Louisse J; Peijnenburg A
Critical reviews in toxicology
Occupational differences in COVID-19 incidence, severity, and mortality in the United Kingdom: Available data and framework for analyses.
Pearce N; Rhodes S; Stocking K; Pembrey L; van Veldhoven K; Brickley EB; Robertson S; Davoren D; Nafilyan V; Windsor-Shellard B
Wellcome Open Research
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