Tony Fletcher


Associate Professor

Room 219

15-17 Tavistock Place
United Kingdom

+44 (0)20 7927 2429

+44 (0)20 7927 2701

I have been at LSHTM since 1992, in the Environmental Epidemiology Unit and subsequently the Public and Environmental Health Research Unit. In 2007 I became an Adjunct Research Professor in Environmental Health in the School of Public Health, Boston University, Massachusetts, USA. Prior to joining the school I worked in occupational epidemiology and occupational health teaching in Aston and Birmingham Universities, and occupational cancer research at the International Agency for Research in Cancer in Lyon, France.


Department of Social and Environmental Health Research


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


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

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.

Survey of health complaints among sheep-dippers "SHAPE"

Survey of 1000+ sheep farmers focussing on the potential health effects of exposure to organophosphates during sheep "dipping". Funding from UK MAFF (now DEFRA). Jan 2001-August2003.

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.

Selected Publications

Lifetime exposure to arsenic in residential drinking water in Central Europe
Hough, R.L.; Fletcher, T.; Leonardi, G.S.; Goessler, W.; Gnagnarella, P.; Clemens, F.; Gurzau, E.; Koppova, K.; Rudnai, P.; Kumar, R.; Vahter, M.
International Archives of Occupational and Environmental Health
Mortality in British military participants in human experimental research into chemical warfare agents at Porton Down: cohort study
Venables, K.M.; Brooks, C.; Linsell, L.; Keegan, T.J.; Langdon, T.; Fletcher, T.; Nieuwenhuijsen, M.J.; MacOnochie, N.E.S.; Doyle, P.; Beral, V.; Carpenter, L.M.
Polymorphisms in DNA Repair Genes, Smoking, and Bladder Cancer Risk: Findings from the International Consortium of Bladder Cancer.
Stern, M.C.; Lin, J.; Figueroa, J.D.; Kelsey, K.T.; Kiltie, A.E.; Yuan, J.M.; Matullo, G.; Fletcher, T.; Benhamou, S.; Taylor, J.A.; Placidi, D.; Zhang, Z.F.; Steineck, G.; Rothman, N.; Kogevinas, M.; Silverman, D.; Malats, N.; Chanock, S.; Wu, X.; Karagas, M.R.; Andrew, A.S.; Nelson, H.H.; Bishop, D.T.; Sak, S.C.; Choudhury, A.; Barrett, J.H.; Elliot, F.; Corral, R.; Joshi, A.D.; Gago-Dominguez, M.; Cortessis, V.K.; Xiang, Y.B.; Gao, Y.T.; Vineis, P.; Sacerdote, C.; Guarrera, S.; Polidoro, S.; Allione, A.; Gurzau, E.; Koppova, K.; Kumar, R.; Rudnai, P.; Porru, S.; Carta, A.; Campagna, M.; Arici, C.; Park, S.S.; Garcia-Closas, M.; for the International Consortium of Bladder Cancer, .;
Cancer Res
Occupational exposure to crystalline silica and risk of lung cancer - A multicenter case-control study in Europe
Cassidy, A.; T Mannetje, A.; van Tongeren, M.; Field, J.K.; Zaridze, D.; Szeszenia-Dabrowska, N.; Rudnai, P.; Lissowska, J.; Fabianova, E.; Mates, D.; Bencko, V.; Foretova, L.; Janout, V.; Fevotte, J.; Fletcher, T.; Brennan, P.; Boffetta, P.
Single nucleotide polymorphisms in DNA repair genes and basal cell carcinoma of skin.
Thirumaran, R.K.; Bermejo, J.L.; Rudnai, P.; Gurzau, E.; Koppova, K.; Goessler, W.; Vahter, M.; Leonardi, G.S.; Clemens, F.; Fletcher, T.; Hemminki, K.; Kumar, R.;
Toward guidelines for the ethical reanalysis and reinterpretation of another's research.
Neutra, R.R.; Cohen, A.; Fletcher, T.; Michaels, D.; Richter, E.D.; Soskolne, C.L.;
NO2 and children's respiratory symptoms in the PATY study.
Pattenden, S.; Hoek, G.; Braun-Fahrländer, C.; Forastiere, F.; Kosheleva, A.; Neuberger, M.; Fletcher, T.;
Occup Environ Med
Lung cancer risk after exposure to polycyclic aromatic hydrocarbons: a review and meta-analysis.
Armstrong, B.; Hutchinson, E.; Unwin, J.; Fletcher, T.;
Environ Health Perspect
See all Tony Fletcher's Publications