Career Resume

Dr. Kilburn graduated from the University of Utah College of Medicine in 1954. He completed postgraduate training in internal medicine at Western Reserve University (internship), University of Utah Hospitals (residency in Medicine and in Pathology), and Duke University (fellowship in cardio-pulmonary disease). In 1958, he developed a cardiopulmonary research laboratory with a staff of 15 at the U.S. Army Medical Research and Nutritional Laboratory at Fitzsimmons Army Hospital. Six papers were published. Following these two years, he trained in clinical cardiology with the late Dr. Paul Wood in London, England.

He returned to the United States in 1961 to organize the first cardiopulmonary division for Washington University (at Barnes Hospital), St. Louis. His effect on the house staff included 5 of 20 interns going into pulmonary disease.

He returned to Duke in 1963 to organize and head the medical service of the Durham Veterans Administration as an integral partner with Dr. Eugene Stead at Duke Hospital. Faculty and housestaff training was emphasized. The cardiology sections and pulmonary were strengthened including intensive care and research laboratories. Respiratory failure was studied prospectively together with clearance mechanisms of the lung and ciliary beating. After five years of administration a sabbatical was taken in ultrastructure of the lung.

A new and novel division of Environmental Medicine was developed and organized by Dr. Kilburn at Duke from 1968-73. The epidemiology of textile workers' lung disease (byssinosis) was pursued in cooperation with the North Carolina Department of Health and Burlington Industries, the textile giant. The basic biology of ciliary beating, of lung surfactant and glycoproteins in alveolar proteinosis and effects of inhalants such as cotton dust and cigarette smoke on airway lining cells were investigated in a model for scientific solving of societal problems. The division had a faculty of 12 and a staff of 25. Ten M.D.'s and Ph.D.'s were trained in environmental medicine each 2 years.

In 1973, Dr. Kilburn went to the University of Missouri to establish its first pulmonary and environmental medicine program.

In 1977, Dr. Kilburn returned to society's environmental and occupational medicine frontier by joining Dr. Irving J. Selikoff in the Environmental Sciences Laboratory at Mt. Sinai School of Medicine in New York. Among his roles was the development of "mechanisms of diseases" laboratories to complement Selikoff's epidemiological laboratories.

In 1980, Dr. Kilburn accepted the Ralph Edgington Chair in Medicine at the University of Southern California School of Medicine. In August of 1980, he founded the Barlow-USC Occupational Health Center as a clinical center for the investigation of the adverse health effects of environmental agents. The Pulmonary Division at USC School of Medicine and Los Angeles County-USC Medical Center, with its responsibilities for education, research and patient care, came under Dr. Kilburn's direction in July, 1982.

Research accomplishments included studies of shipyard workers and their household exposed family members which showed 11.3% of wives had signs of asbestosis. The nonsmoking women in this group showed airflow reductions attributed to Los Angeles air pollution. The repeat study of 330 of these women, four years after the initial study confirmed the role of air pollution. Over 1,200 Los Angeles school children in 2nd and 5th grades were studied by spirometry for functional status as compared to Houston children as controls and by questionnaire for the prevalence of asthma, chronic bronchitis, the response to bronchodilators, and effects of household cigarette smoking and of Los Angeles smog. Not only were their pulmonary flows reduced as compared to those in Houston but their flows decreased across three years.

A longitudinal study of pulmonary and neurobehavioral effects of formaldehyde showed acute and progressive effects on pulmonary function. Furthermore, 6 of 10 neurobehavioral tests were reduced by hours of formaldehyde in regression analysis after age had reduced 8 of 10 tests.

A cross-shift study of stainless steel welding showed reduced flow rates during work, but more disturbing, cigarette-smoking welders had more functional impairment than smoking specific referents.

From 1986-1993 nearly 16,000 asbestos exposed shipyard and construction workers were studied to characterize the physiological impairments as obstruction of small airways with air trapping to reduced vital capacity and diffusing capacity. The under- measurement of total lung capacity using gas dilution was defined. These asbestosis studies and normal values for total lung capacity based on standard population were published.

Since 1986, following the study of neurobehavioral performance in histology technicians, nearly 2400 subjects exposed to environmental chemicals have been characterized by neurophysiological tests of balance, reaction time, blink reflex latency, color discrimination and a cognitive and perceptual motor test battery including affective status with a profile of mood states. Toluene, trichloroethylene, hydrogen sulfide and chlorinated dibenzodioxanes are the major neurotoxicants associated with impaired performance. Apparatus for field testing of balance, blink and reaction time have been developed and tested and results published. These studies have led to over 10 publications and 12 papers and two books are in development.